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The AAP Library
Take advantage of these resources on various health issues related to adolescents. Some of these resources were authored and/or coauthored by members of the AAP staff (including several books, book chapters, and articles).

Order a copy of the award-winning book, Lesbian and Gay Youth: Care and Counseling, Ryan, C. & Futterman, D. (1998), at a special discounted price of $20 plus shipping charges. Order it now!

Scientific Journal Articles on Youth and HIV
Chabon, B. & Futterman, D. (1999). Adolescents and HIV. AIDS Clinical Care, 11 (2), 9-16.

Futterman, D., Hein, K., Reuben, N., Dell, R., Shaffer, N. (1993). Human immunodeficiency virus-infected adolescents: The first 50 patients in a New York City program. Pediatrics, 91 (4), 730-735.

Hoffman, N. D. & Futterman, D. (1993). Human immunodeficiency virus infection in adolescents. Seminars in Pediatric Infectious Diseases, 4 (2), 113-121.

Hoffman, N., Futterman, D. & Myerson, A. (1999). Treatment issues for HIV-positive adolescents. AIDS Clinical Care, 11 (3), 17-24.

Rogers, A. S., Futterman, D., Levin, L., D’Angelo, L. (1996). A profile of human immunodeficiency virus-infected adolescents receiving health care services at selected sites in the United States. Journal of Adolescent Health, 19, 401-408.

Ryan, C. & Futterman, D. (1998). Caring for gay and lesbian teens. Contemporary Pediatrics, 15 (11), 107-130.
Journal edition written by AAP staff re: development and implementation of adolescent-specific HIV/AIDS program:

Kunins, H, Hein, K., Futterman, D., Tapley, E., & Elliot, A. S. (1993). Guide to Adolescent HIV/AIDS Program Development. Journal of Adolescent Health, 14 (5, Supplement), 1-140.

Gay and Lesbian Youth
Below is a listing of resources

Alexander, C. J. (1998). Studying the experiences of gay and lesbian youth. Journal of Gay and Lesbian Social Services, 8 (2), 69-72. Explores how gay, lesbian, and bisexual youth are integrated into society. The sexual minority youth of today have greater opportunities for development and acceptance than older gays and lesbians had, however, gay youth are still at high risk for confusion, societal pressure, and feelings of self-destruction and isolation.

Anderson, A. L. (1998). Strengths of gay male youth: An untold story. Child and Adolescent Social Work Journal, 15 (1), 55-71. This exploratory study found that gay male youths develop strengths that enable them to successfully cope with the challenges and stresses associated with their overall development. These internal and external resources were (1) protective in nature, (2) indicated the presence of resilience, and (3) assisted participants in managing their sexual orientation in adolescence. Bivariate analysis revealed participants had positive self-esteem and an interval locus of control comparable to, or better than, youths overall. Age, social support from gay, lesbian, and bisexual friends and from family, and a preadolescent sense of difference were significantly correlated with self-esteem and/or locus of control.

Anderson, D. A. (1994). Lesbians and gay adolescents: Social development considerations. High School Journal, 77 (1-2), 13-19. There are adolescents who have already identified themselves as predominately homosexual, or who will later come to so identify themselves. For these adolescents, social and emotional development during adolescence are likely to differ in significant ways. There is almost no prospective research on the development of sexual orientation. The studies of gay and lesbian adolescents that have been done seem to confirm that a similar process is taking place. The author discusses these similarities in terms of homosexual arousal and behavior, homosexual experiences, heterosexual experiences, awareness of homoerotocism, coming out to others, developing a lesbian or gay identity, cross gender behavior and peer relationships.

Anderson, D. A. (1987). Family and peer relations of gay adolescents. Adolescent Psychiatry, 14, 162-178. In this paper, the author describes a support group for gay adolescence and some of the special issues of development that confront these young people. There is a description of the group itself, members relationships with their families including hiding from parents as well as parental reactions, anger, and guilt. Case examples are used to illustrate both the family relations as well as the adolescent’s own process of acknowledgement.

Anderson, J. D. (1997). Supporting the invisible minority. Educational Leadership, 54, 65-68. A hidden minority group of gay and lesbian students attend our schools. This article is the story of pioneering educators in Stratford, Connecticut, who have provided a leadership model to meet the needs of these students. Their techniques include the coming out of leadership, professional development, library resources, curriculum support, and adding homosexuality to the health curriculum.
Anderson, J. D. (1994). Including gay/lesbian students and staff. The Education Digest, 60, 35-39. Homophobia comes in many flavors. Some people are simply hateful, but most are not. The conspiracy of silence is not based on malice. There are too many good people in education for that to be true. This article shows how to create a supportive environment through professional development, support staff and services, including sexuality in the health care curriculum, the general curriculum and the library.

Anderson, L. R., & Randlet, L. (1994). Self-monitoring, perceived control and satisfaction with self-disclosure of sexual orientation. Journal of Social Behavior and Personality, 9 (4), 789-800. A survey of 155 lesbians, gay men and bisexual men and women included the Revised Self-Monitoring Scale, the Interpersonal Control Scale and items assessing satisfaction with the process of coming out. We predicted (1) high self-monitors would be more satisfied than low self-monitors with the process of self-disclosing nontraditional sexual orientations, and (2) the relationship between self-monitoring and satisfaction would be enhanced when high self-monitors also had high perceived control. Both hypotheses were supported. Moderated regressions, controlling demographics, indicated self-monitoring Factor A was significantly related to satisfaction with disclosure of sexual orientation. Perceived control produced significant interactions with both self-monitoring Factor A and Factor B in relation to satisfaction. Conclusions suggest that high self-monitors were more satisfied because they employed a situation-specific strategy for disclosing or not disclosing their sexual orientations. A heightened sense of interpersonal control would then bolster confidence and accuracy of high self-monitor’s situational tactics for divulging their sexual orientations.

Anderson, L. R., & Randlet, L. (1993). Self-monitoring and life satisfaction of individuals with traditional and nontraditional sexual orientations. Basic and Applied Social Psychology, 14 (3), 345-361. Our previous work found that high self-monitoring enhanced the job effectiveness of individuals in gender non-traditional occupations, such as men in nursing and women in management. This study tested whether self-monitoring would enhance the life satisfaction of individuals with nontraditional sexual orientations: lesbians and gay men. The Revised Self-monitoring Scale and the Life Satisfaction Index were completed by 1332 gay and lesbian individuals and by 137 heterosexuals. Moderated regressions indicated self-monitoring was significantly related to life satisfaction of all individuals but there was no interaction with sexual orientation. Significant interactions between self-monitoring, gender, and relationship status indicated self-monitoring Factor A, and Factor B, Sensitivity to the Expressive Behavior of Others, bolstered the life satisfaction of all women in relationships. Regardless of sexual orientation, women had higher life satisfaction scores than men. The failure of the principal hypothesis suggests that the previously identified enhancement effect of self-monitoring may be limited to public occupational roles where social skills of impression management are requisite to effective job performance. The enhancement effect may not extend to private aspects of personal identity. [SOD]

Arnett, J. J. (1999). Adolescent storm and stress, reconsidered. American Psychologist, 54 (5), 317-326. G. S. Hall’s (1904) view that adolescence is a period of heightened “storm and stress” is reconsidered in light of contemporary research. The author provides a brief history of the storm-and-stress view and examines 3 key aspects of this view: conflict with parents, moff disrcuptions, and risk behavior. In all 3 areas, evidence supports a modified storm-and-stress view that takes into account individual differences and cultural variations. Not all adolescents experience storm and stress, but storm and stress is more likely during adolescence than at other ages. Adolescent storm and stress tends to be lower in traditional cultures than in the West but may increase as globalization increases individualism. Similar issues apply to minority cultures in American society. Finally, although the general public is sometimes portrayed by scholars as having a stereotypical view of adolescent storm and stress, both scholars and the general public appear to support a modified storm-and-stress view.

Bailey, N. J., & Phariss, T. (1996). Gay students in middle school. The Education Digest, 62, 46-49. In 1993, the National Middle School Association resolved to encourage middle schools to gather information on school politics and programs on the needs and problems of gay, lesbian, and bisexual youth. The authors briefly summarize some of the statistics they found. They also list several suggestion by educator James T. Sears and Kevin Jennings (Executive Director of the Gay, Lesbian, Straight Education Network) for making positive changes in the schools.

Bartholow, B. N., Doll, L. S., Joy, D., Douglas, J. M., Bolan, G., Harrison, J. S.,. Moss, P. M., & McKirnan, D. (1994). Emotional, behavioral, and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse & Neglect, 18 (9), 747-761. From May 1989 through April 1990, 1,001 adult homosexual and bisexual men attending urban sexually transmitted disease clinics were interviewed regarding abusive sexual contacts during childhood and adolescence. Sexual abuse was found to be significantly associated with mental health counseling and hospitalization, psychoactive substance abuse, depression, suicidal thought or action, social support, sexual identity development, HIV risk behavior including unprotected anal intercourse and injecting drug use, and risk of sexually transmitted diseases including HIV infection. Data suggest that sexual abuse may have a wide-ranging influence on the quality of life and health risk behavior of homosexual men. Increased awareness as to the potential outcomes of male sexual abuse is critically important to the design and implementation of medical and psychological services for sexually abused men.

Bauman, S., & Sachs-Kapp, P. (1998). A school takes a stand: Promotion of sexual orientation workshops by counselors. Professional School Counseling, 1 (3), 42-45. The authors describe a program in which students organize and facilitate school-wide workshops on such pertinent topics as racism, gender equity, and religious discrimination. The most effective and controversial of these events were those that focussed on sexual orientation, which is the focus of the paper. The school counselors assumed responsibility for recruiting and training students to be leaders in this endeavor.

Berger, R. M. (1990). Passing: Impact on the quality of same-sex couple relationships. Social Worker, 35 (4), 328-332. Passing is the social process by which gay men and lesbians present themselves to the world as heterosexuals. A questionnaire survey of same-sex couples, recruited through a national support organization, examined the impact of passing on relationship quality. Passing was not related to self-reported love for partner. However, respondents who were known to significant others as homosexual were more likely to report satisfaction with their relationships. Social workers providing services to gay and lesbian couples are alerted to the primary role played by significant others in the same-sex couple relationship.

Berger, R. M. (1992). Passing and Social Support Among Gay Men. Journal of Homosexuality, 23 (3), 85-97. One hundred sixty-six gay men responded to a questionnaire survey which asked them to describe their social networks and the extent to which they “passed” (were assumed to be heterosexual) among network members. Most gay men were known as gay to most members of their networks; however, friends, siblings and persons close to respondents were more likely to be aware of their homosexuality than co-workers, parents, and more distant relatives. Gay men were more satisfied with social support available from those who knew of their sexual orientation. The author concludes that passing has important and complex effects on the social networks of gay men.

Bieschke, K. J., & Matthews, C. (1996). Career counselor attitudes and behaviors toward gay, lesbian, and bisexual clients. Journal of Vocational Behavior, 48, 243-255. In the past few years there has been an increase in journal articles discussing the unique career concerns of those who identify themselves as gay, lesbian, or bisexual. Articles have also examined the variables that may influence counselor responsiveness to such concerns. Nonetheless, there is no empirical evidence that documents the extent to which career counselors perceive themselves to engage in behaviors that are affirmative of gay, lesbian, and bisexual clients. This study surveyed 106 career counselors as university career counseling centers. Regression analyses were conducted to determine the factors predictive of higher levels of culturally affirmative behavior with clients who identified themselves as gay, lesbian, or bisexual, and with all clients. With both populations, the most predictive factors were an organizational climate that is nonheterosexist and the counselor’s sexual orientation. A significant predictor of culturally affirmative behaviors with all clients was the extent to which counselors defined a broad diversity of populations as cultural minorities. The implications of these results as well as limitations and needs for further research are discussed.

Black, J., & Underwood, J. (1998). Young, female, and gay: Lesbian students and the school environment. Professional School Counseling, 1 (3), 15-20. Lesbian youth are particularly vulnerable to nonexistence, as they are frequently not acknowledged during their adolescence. As a female, the lesbian youth is expected to adhere to a sexist code of obedience, silence, and invisibility. For many lesbians, successful completion of adolescent development won’t occur until later in life. The authors discuss the lesbian adolescent in terms of homophobia, identity development, isolation and passing, coming out, and minority issues. They also suggest strategies and provide resources for school counselors in terms of direct-intervention, staff development, educating parents and families of lesbian students, and enriching the school environment.

Blumenfeld, W. J. (1994). "Gay/straight" alliances: Transforming pain to pride. High School Journal, 77 (1-2), 113-121. This article describes how gay/straight alliances are being formed in high schools. It talks about the pain behind the need for such groups, and the pride that can develop in all the student participants if and when the groups are allowed to flourish.

Bolton, F. G., & MacEachron, A. E. (1988). Adolescent male sexuality: A developmental perspective. Journal of Adolescent Research, 3 (3-4), 259-273. Viewed from a developmental perspective, adolescent male sexuality is the time of transition from childhood experimentation to satisfactory adult sexuality. This transition is often difficult because of misinformation or lack of empirically accurate information about sexuality, cultural expectations of masculinity defined by gender roles, and differential parental and peer socialization of males from infancy through adolescence. The quest for adult masculinity and sexuality for adolescent males is further complicated by a social context that exaggerates fears of femininity and homophobia and that overlooks their sexual behavior in the areas of adolescent fatherhood and adolescent sexual offenders. [SOD]

Borhek, M. V. (1988). Helping gay and lesbian adolescents and their families: A mother's perspective. Journal of Adolescent Health Care, 9 (2), 123-128. Gay and lesbian youths confront a number of difficult problems, including telling their parents about their sexual orientation and helping their families adjust to the news. Ineffective communication, poor self-esteem, and unresolved grief and anger often complicate the adolescents telling his or her parents. Frequently, misinformation about homosexuality, religious beliefs, and homophobia adversely influence parental reactions. Impediments to the relationship between parents and sexual-minority youth are discussed, and strategies to promote positive family adjustment are presented.

Boxer, A. M., & Cohler, B. J. (1989). The life course of gay and lesbian youth: An immodest proposal for the study of lives. Journal of Homosexuality, 17 (3-4), 315-355. The authors raise questions about several fundamental assumptions and methods regarding study of the development of gay and lesbian youth. Primary among these are the validity of the reliance on respondent’s recollections regarding their childhood and adolescent experiences; inferences about developmental processes and outcomes made on the basis of cross-sectional samples; the time-specific, cohort-bound nature of many previous constructs and findings; and the persistent search for continuities between childhood gender behavior and adult sexual orientation. In consequence, the emerging body of theory is largely a developmental psychology of the remembered past. Strategies are suggested for longitudinal, prospective research on homosexual adolescents, shifting attention from child-based, casual models to those of adolescent and adult-centered perspectives. Aimed at understanding life changes and the developmental processes and course of negotiating them, longitudinal methods will more accurately reflect current experiences of gay and lesbian youth coming of age in a unique historical context. Findings from studies of the life course have direct implications for modification of current developmental theories, particularly those that can inform gay and lesbian-sensitive clinical services for all age groups. [SOD]

Braverman, P. K., & Strasburger, V. C. (1993). Adolescent sexual activity. Clinical Pediatrics, 32 (11), 658-668. Adolescents are becoming sexually active at younger ages. One half of the adolescents in the United States are sexually active. This article reviews adolescent sexual activity, including rates of sexual activity, sexual practices, gay and lesbian youth, and factors affecting the initiation of sexual activity. In addition, adolescent pregnancy, with possible outcomes and effects on teen parents and their offspring, is discussed.

Bridget, J., & Lucille, S. (1996). Lesbian youth support information service (LYSIS): Developing a distance support agency for young lesbians. Journal of Community & Applied Social Psychology, 6, 355-364. The Lesbian Youth Support Information Service (LYSIS) was established in 1991 as a result of research conducted into the needs and experiences of young lesbians. This research found that young lesbians are vulnerable to mental health problems, including depression, attempted suicide, self-harming behaviours and alcohol misuse, as well as isolation and social rejection. There were also strong indications that young lesbians are most vulnerable when they are coming to terms with their sexual orientation. LYSIS offers support to young lesbians in four main ways: correspondence counseling, telephone counseling; peer support; and information. LYSIS is part of an umbrella organization, the Lesbian Information Service (LIS), which provides indirect support for young lesbians including publishing, education and training, projects and campaigning.

Carballo-Dieguez, A. (1989). Hispanic culture, gay male culture, and AIDS: Counseling implications. Journal of Counseling and Development, 68, 26-30. The AIDS epidemic is affecting Hispanics in disproportionately high numbers. High-risk sexual behavior conducive to HIV infection seems to continue taking place among Hispanic gay men. This article presents some necessary considerations when counseling this population.

Carre, N., Deveau, C., Belanger, F., Boufassa, F., Persoz, A., Jadand, C., Rouzioux, C., Delfraissy, J., Bucquet, D., & the SEROCO study group. (1994). Effect of age and exposure group on the onset of AIDS in heterosexual and homosexual HIV-infected patients. AIDS, 8, 797-802. This multicenter prospective cohort study involved 443 subjects whose date of HIV infection was known to within +1 year. Individuals whose sexual behavior was exclusively homosexual after HIV infection constituted the heterosexual group (n=131). AIDS-free survival was compared with that of men (n=312) infected through homosexual sex and who continued homosexual activity after HIV infection. They constituted the homosexual group. The end-point was the onset of an AIDS-defining illness listed in the 1987 revised Centers for Disease Control and Prevention (CDC) criteria. Using the Kaplan-Meier method, AIDS-free survival curves were plotted for three age categories (<20, 20-39, >40 years). A Cox Model was used to quantify the effect of age and to assess the influence of exposure group on AIDS onset after adjustment for age. Because of the high incidence of Kaposi’s sarcoma (KS) among homosexual men, a disease that can be an early AIDS-defining illness, multivariate analysis was performed with and without consideration of the occurrence of KS. Patients aged >40years at seroconversion progressed more rapidly to AIDS than younger patients. When age was fitted as a continuous variable and adjusted for exposure group, the relative risk of developing AIDS by any time after seroconversion was 1.34 for a 10-year increase difference. After adjustment for age, the relative risk of developing AIDS (CDC criteria) was 2.42 among the homosexual men. All cases of KS (n=19) involved the homosexual group. Excluding KS as a first manifestation of AIDS, homosexual or bisexual subjects had a risk of AIDS of 1.92 compared with heterosexual subjects. The risk of AIDS increases with age at seroconversion. The more rapid progression towards AIDS in the homosexual group than in the heterosexual group persisted after adjustment for age. Further studies are required to determine the possible role of repeated exposure to HIV or other pathogens acquired sexually.

Casper, V., Cuffaro, H. K., Schultz, S., Silin, J. G. et al (1996). Toward a most thorough understanding of the world: Sexual orientation and early childhood education. Harvard Educational Review, 66 (2), 271-293. Written collaboratively by five educators from the Bank Street College of Education, this article focuses on sexual orientation and early childhood education, an issue that is often overlooked. The authors describe research projects they have undertaken to explore elementary school teachers’ thoughts and attitudes about sexual orientation in relation to children’s sexuality and parents’ sexual orientation. Building from there, they examine the connections between teachers’ reflections of their own childhood experience and their current attitudes toward sexual orientation. They then move from exploring adult conceptions of family to examining those of children. Finally, the authors describe the process of transformation at Bank Street College as the institution struggled to include gay and lesbian lives in the early childhood and graduate school curriculum. Throughout the article, the authors continually connect their proactive stance for inclusion around sexual orientation with their larger vision of a more just and equitable society. [SOD]

Cates, J. A. (1987). Adolescent sexuality: Gay and lesbian issues. Child Welfare, 66 (4), 353-364. Dynamics and interventions with adolescents who express concern regarding gay/lesbian issues are described, with a focus both intrapsychic and social. Both psychological and emotional aspects of sexual preference, and cultural and social expectations for those who identify themselves as gay of lesbian are considered.

Chekola, M. (1994). Outing, truth-telling, and the shame of the closet. Journal of Homosexuality, 27(3-4), 67-90. This essays examines the nature of being in the closet, coming out, and the practice of outing. It is argues that no general rule against outing can be maintained since outing others may be defensible as one pursues one’s own legitimate legal and moral interests. Neither does privacy extend to all aspects of human life which someone may wish to keep secret, especially if information about sexual orientation is not obtained in any immoral way. Withholding information about sexual orientation may sometimes be justified but on grounds of secrecy and not in a way that always forbids outing. The shame and degradation of the closet are evils, but outing is not necessarily their solution, though any loss of “privacy” entailed by coming out of the closet can be more than compensated by the rewards of casting off implications of worthlessness.

Christensen, S., & Sorenson, L. M. (1994). Effects of a multi-factor education program on the attitude of child and youth worker students toward gays and lesbians. Child and Youth Care Forum, 23 (2), 119-133. Reports for gay and lesbian youth suggest that negative attitudes of caregivers impair their effectiveness. A program addressing attitudes, behavior and cognitions was designed to effect and maintain positive attitudes toward their client group. Thirty-five child and youth worker students participated in one of two 6-hour programs: one provided increased exposure to gay/lesbian lives; the other examined youth suicide. Change was assessed in two post-tests. Experimental subjects had significantly more positive scores on the affective and cognitive measures, but did not differ on the behavioral measure. Group means on all three measures did not differ significantly four weeks later. These results indicate negative attitudes can be moderated. Means of maintaining this positive change are suggested and implications for the education of service providers are discussed.

Chung, Y. B., & Katayama, M. (1998). Ethnic and sexual identity development of Asian American lesbian and gay adolescents. Professional School Counseling, 1 (3), 21-25. Counseling issues pertaining to lesbian and gay adolescents have received increased attention in the literature during the past few years yet the impact of ethnicity has largely been ignored. The purpose of this article is to discuss the ethnic and sexual identity development and the interaction between the two identities among Asian-American lesbian and gay adolescents.

Cohen, L, de Ruiter, C., Ringelberg, H., & Cohen-Kettenis, P. T. (1997). Psychological functioning of adolescent transsexuals: Personality and psychopathology. Journal of Clinical Psychology, 53 (2), 187-196. Adolescent transsexuals were compared with adolescent psychiatric outpatients and first-year university students to determine the extent to which other psychopathology is a necessary condition for the development of transsexualism. These areas of psychological functioning associated with fundamental psychological disturbances – perceptual inaccuracy, disorders of thought and negative self-image – were assessed by means of the Rorschach Comprehensive System. The group of adolescent transsexuals was found to be intermediate between adolescent psychiatric patients and nonpatients for extent of perceptual inaccuracy. They did not differ significantly from nonpatients with regard to thinking disturbances and negative self-image. The psychiatric patients included significantly more individuals characterized by negative self image than the other groups. The results support the idea that major psychopathology is not required for the development of transsexualism.

Cole, S. W., Kemeny, M. E., Taylor, S. E., Visscher, B. R. (1996). Elevated physical health risk among gay men who conceal their homosexual identity. Health Psychology, 15 (4), 243-251. This study examined the incidence of infectious and neoplastic diseases among 222 HIV-seronegative gay men who participated in the Natural History of AIDS Psychosocial Study. Those who concealed the expression of their homosexual identity experienced a significantly higher incidence of cancer (odds ratio = 3.18) and several infectious diseases (pneumonia, bronchitis, sinusitis, and tuberculosis; odds ratio = 2.91) over a 5-year follow-up period. These effects could not be attributed to differences in age, ethnicity, socioeconomic status, repressive coping style, health-relevant behavioral patterns (e.g., drug use, exercise), anxiety, depression, or reporting biases (e.g., negative affectivity, social desirability). Results are interpreted in the context of previous data linking concealed homosexual identity to other physical health outcomes (e.g., HIV progression and psychosomatic symptomatology) and theories linking psychological inhibition to physical illness.

Coleman, E. (1989). The development of male prostitution activity among gay and bisexual adolescents. Journal of Homosexuality, 17 (1-2), 131-149. The current research literature regarding male-juvenile prostitution activity is reviewed. An attempt is made to develop some theoretical understanding of the development of this activity among gay and bisexual adolescents. A predisposition, resulting from faulty psychosexual and psychosocial development, appears to make these boys vulnerable to the situational variables that they encounter. More severe disruptions in psychosexual and psychosocial development seem to result in more destructive and non-ego-enhancing prostitution activities. A clinical case study is presented which illustrates the development of this activity. Recommendations are made to help reduce the amount of self-destructive prostitution activity among male adolescents.

Comely, L. (1993). Lesbian and gay teenagers at school: How can educational psychologists help? Educational and Child Psychology, 10 (3), 22-24. Educational psychology (EP) training and service provision on lesbian and gay issues were surveyed by means of a mailed questionnaire. Responses were received from tutors on 85 percent (n=11) of all EP courses, and from Principal EPs of 35 percent (n=38) of all EP services in England and Wales. Analysis of the results shows serious failings in regard to lesbian and gay issues in training and service delivery.

Committee on Adolescence (1993). Homosexuality and Adolescence. The American Academy of Pediatrics issues its first statement on homosexuality in 1983. The decade that followed witnessed an increased awareness of homosexuality, changing attitudes toward this sexual orientation, and the growing impact of HIV. This is a timely updated statement on homosexuality. [SOD]

Cooley, J. J. (1998). Gay and lesbian adolescents: Presenting problems and the counselor's role. Professional School Counseling, 1 (Feb), 30-34. The author has identified five major presenting problems that gay and lesbian youth face: (1) the development of a social identity, (2) isolation, (3) educational issues, (4) family issues, and (5) health risks. Following a summary of research for each problem, the author identifies the counselor’s role for intervention, treatment, and/or instituting change.
Cramer, D. W., & Roach, A. J. (1988). Coming out to mom and dad: A study of gay males and their relationships with their parents. Journal of Homosexuality, 15 ( 3-4), 79-91. This study explores the relationships between gay men coming out to parents and specific perceived parental variables in an attempt to discriminate between parents who are more or less accepting. In addition, other factors such as how the disclosure occurs and reasons for coming out were investigated. Results indicated that most parents initially react negatively to the disclosure, but become more accepting over time. Parental values and characteristics associated with homophobia were found to be good predictors of the change in parent-son relationship following disclosure. However, the predictions were often in unexpected directions. The majority of respondents reported having a more positive relationship with their mothers than with their fathers, both before and after coming out.

D’Augelli, A. R. (1993). Preventing mental health problems among lesbian and gay college students. The Journal of Primary Prevention, 13 (4), 245-261. Young adults who self-identify as lesbian, gay, or bisexual experience major stresses in managing their sexual orientation. They are at risk for serious mental health problems, including suicide and depression. The mental health concerns of lesbian and gay male college students are reviewed. These problems result from the difficulties involved in developing a lesbian or gay personal identity, and are exacerbated by widespread negative attitudes, harassment, and violence directed toward lesbians and gay men on college campuses. Several systemic preventive interventions are recommended to decrease mental health problems in this population.

D’Augelli, A. R. (1992). Lesbian and gay male undergraduates’ experiences of harassment and fear on campus. Journal of Interpersonal Violence, 7 (3), 383-395. Harassment and discrimination based on sexual orientation was studied in a sample of 121 undergraduate students between 19 and 22 years of age. Over three fourths of the respondents reported verbal abuse and over one fourth had been threatened with violence. Other students were the most frequent victimizers. Few reported victimization to authorities. Fear for one’s personal safety on campus was related to frequency of personal harassment. The implications of harassment and discrimination on the development of young lesbian and gay men are discussed.

D’Augelli (1991) Gay men in college: Identity processes and adaptations. Journal of College Student Development, 32, 140-146. Disclosure to families remains a major challenge for young gay men as they consolidate the many components of their personal identity in college. Although most lesbian and gay adults acknowledge their affectional orientation to themselves during adolescence, most have not come out by the time they enter a college or university. Only a small minority of lesbian and gay youth disclose in junior or senior high school, and these youth often suffer serious psychological and family consequences. For those who do go to college, the modal pattern is to disclose during their college years, away from the scrutiny of family and friends. [SOD]

D’Augelli, A. R. (1989). Lesbians’ and gay men’s experiences of discrimination and harassment in a university community. American Journal of Community Psychology, 17 (3), 317-321. A survey of 125 lesbians and gay men in a university community was conducted to determine the incidence of discrimination, harassment, and violence. Nearly three fourths had experienced verbal abuse; 26% were threatened with violence; and 17% had personal property damaged. Students and roommates were most often those responsible. Most incidents were not reported to authorities, and many made changes in their daily routines to avoid harm. Over half of the sample feared for their personal safety; their fear was related to the amount of harassment and previous property damage. Men were more often victimized than women.

D’Augelli, A. R., & Hershberger, S. L. (1993). Lesbian, gay, and bisexual youth in community settings: Personal challenges and mental health problems. American Journal of Community Psychology, 21 (4), 421-448. Studied 194 lesbian, gay, and bisexual youth aged 21 and younger who attended programs in 14 community centers to determine the personal challenges they face due to their sexual orientation and their responses to these stresses. First awareness of sexual orientation typically occurred at age 10, but disclosure to another person did not occur until about age 16. There was much variability in sexual behavior, and many youths reported both same-sex and opposite-sex sexual experiences. Although most had told at least one family member about their sexual orientation, there remained much concern about family reactions. Suicide attempts were acknowledged by 42% of the sample. Attempters significantly differed from nonattempters on several milestones of sexual orientation development, social aspects of sexual orientation, parents’ knowledge of sexual orientation, and mental health problems.

D’Augelli, A. R., Hershberger, S. L., & Pilkington, N. W. (1998). Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences. American Journal of Orthopsychiatry, 68 (3), 361-371. Lesbian, gay, and bisexual youngsters, aged 14-21 and living at home, were studied for patterns of disclosure of sexual orientation to families. Three-quarters had told at least one parent, more often the mother than the father. Those who had disclosed were generally more open about their sexual orientation than those who had not, and few of the nondisclosed expected parental acceptance. Those who had disclosed reported verbal and physical abuse by family members, and acknowledged more suicidality than those who had not “come out” to their families.

Davenport, C. W. (1986). A follow-up study of 10 feminine boys. Archives of Sexual Behavior, 15 (6), 511-517. Ten subjects who exhibited feminine behavior and cross-dressing as young boys are described. At follow-up, 8 to 10 years later, 4 are heterosexual, 2 are homosexual, 1 is transsexual, and the outcome is uncertain in 3. Of the eight who met DSM III criteria when evaluated, three are heterosexual, two are homosexual, one is transsexual, and the outcome is uncertain for two. Gender dysphoria appears to be a necessary but not sufficient factor in a transsexual outcome. The strength, rigidity, and persistence of cross-gender behavior through latency may be a good predictor of transsexual outcome. [SOD]

Dawson, J. M., Fitzpatrick, R. M., Reeves, G., Boulton, M., McLean, J., Hart, G. J., & Brookes, M. (1994). Awareness of sexual partners’ HIV status as an influence upon high-risk sexual behaviour among gay men. AIDS, 8, 837-841. Structured interviews and collection of saliva samples for anonymous linked testing for HIV-1 antibodies were conducted to evaluate the extent to which “high-risk” sexual behavior is influenced by awareness of partner’s HIV status among gay men. Men (n=677) who reported sexual contact with another man in the last 5 years were utilized. The majority of the respondents (63%) had had an HIV-antibody test. Analysis of data showed that in 15% of the respondents’ 1380 partnerships, HIV status was known by both parties. However, the majority of partnerships involved only safe sex. Only 26% of the partnerships in which unprotected penetrative anal sex had occurred involved mutual knowledge of HIV status and was most likely to occur with regular rather than non-clinical/casual partners. Logistic regression revealed that this latter association could not be explained in terms of mutual HIV status knowledge. Despite widespread HIV testing, the majority of gay men engaging in high-risk sex are unaware of their partner’s HIV status.

Day, N. E., Schoenrade, P. (1997). Staying in the closet versus coming out: Relationships between communication about sexual orientation and work attitudes. Personnel Psychology, 50, 147-163. The threat of job discrimination causes many gay men and lesbians to keep their sexual orientation secret at work. This study investigates the relationships between extent of communication about sexual orientation and critical work attitudes. We hypothesized that “closeted” gay workers will experience more negative work attitudes than will either “openly” gay or heterosexual workers. The sample consisted of 900 lesbian, gay, and heterosexual workers identified from the mailing list of a civil rights group focused on homosexual rights. The hypothesis is supported for affective organizational commitment, job satisfaction, belief in support of top management, role ambiguity, role conflict, and conflict between work and home issues, but not for continuance commitment. Although casual relationships are not specified, we conclude that work attitude levels of gay and lesbian workers are predicted in part by the amount of communication about their sexual orientation in which these workers engage.

Dean, L. & Meyer, I. (1995). HIV prevalence and sexual behavior in a cohort of New York City gay men (aged 18-24). Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 8, 208-211. An ethnically diverse cohort (n=174) of New York City gay men (aged 18-24) was studied to determine human immunodeficiency virus (HIV) prevalence and to document sexual behavior patterns. Blood tests of 87 men showed an HIV prevalence of 9%, but only 3% of the previously tested men (n=77) reported knowledge of a positive test result at baseline interview. An annual HIV seroconversion rate of 2% was observed. Ethnic minority men were more likely to test HIV positive. In addition, the median number of both sexual episodes and sex partners, and the proportion of men who engaged in anal intercourse, increased significantly for 1990 to 1991. During this 2-year period, 91% of the men engaged in unprotected receptive oral intercourse, and 37% engaged in unprotected receptive anal intercourse.

Dempsy, C. L. (1994). Health and social issues of gay, lesbian, and bisexual adolescents. Families in Society: The Journal of Contemporary Human Services, March,160-167. Ten percent of the adolescent population in the United States is gay, lesbian, or bisexual. These teens are difficult to identify and many people are unaware of their existence, problems, and needs. The author reviews current professional and lay literature regarding social and health issues of adolescent homosexuality and presents implications for practitioners in providing comprehensive, culturally appropriate services for these individuals. [GMI]

De Wit, J. B. F., van den Hoek, J. A. R., Sandfort, T. G. M., & van Griensven, G. J. P. (1993). Increase in unprotected anogenital intercourse among homosexual men. American Journal of Public Health, 83 (10), 1451-1453. Results are presented from two sources, data of which indicate an increase in high-risk sexual behaviors from human immunodeficiency virus among homosexual men. The number of cases of gonorrhea among homosexual and bisexual visitors to municipal sexually transmitted disease clinics in Amsterdam, The Netherlands, is increasing. An increase was also observed in unprotected anogenital intercourse among homosexual participants in the Amsterdam cohort. These findings indicate that a rebound in the behavior change process among homosexual men is occurring. Furthermore, longitudinal behavioral data show that lapse and relapse into unsafe sex are prevalent in the Amsterdam cohort.

Dietz, T. J., & Dettlaff, A. (1997). The impact of membership in a support group for gay, lesbian and bisexual students. Journal of College Student Psychotherapy, 12 (1), 57-72. Many young people are enrolled in colleges and universities during the time they explore their sexual orientation. Although most gay, lesbian, and bisexual youth find ways of achieving positive and healthy identities as adults, many struggle and experience isolation and loneliness. A student organization which provides support for gay, lesbian, and bisexual students may help students through difficult times and facilitate the development of a positive identity. In-depth, qualitative interviews were conducted with 11 gay, lesbian, and bisexual students at a small, church-affiliated university to explore how their membership in a support group affected them. Benefits from group membership include meeting and being with others like themselves; having mentor relationships with other gays, lesbians, and bisexuals; and learning about issues related to homosexuality, all of which can have a positive impact on identity formation.

Dombrowski, D., Wodarski, J. S., Smokowski, P. R., & Bricout, J. C. (1996). School-based social work interventions with gay and lesbian adolescents: Theoretical and practice guidelines. Journal of Applied Social Sciences, 20 (1), 51-61. Adolescents are faced with many obstacles. Many issues affect their lives on a daily basis and have an effect on how they develop into adults. Gay or lesbian adolescents must face the same barriers that normal adolescents face, in addition to the homophobic fears of society. Society’s negativism about gay and lesbian adolescents affects their self-concept and self-esteem, as well as their social interactions with family and friends. Along with the increased risk of contracting sexually transmitted diseases, such as AIDS, these factors bring great stress and fear into the lives of gay and lesbian adolescents. This article addresses the dynamics behind homophobia and proposes an intervention paradigm to help ameliorate the problem.

Eagly, A. H., & Wood, W. (1999). The origins of sex differences in human behavior. American Psychologist, 54 (6), 408-423. The origins of sex differences in human behavior can lie mainly in evolved dispositions that differ by sex or mainly in the differing placement of women and men in the social structure. The present article contrasts these 2 origin theories of sex differences and illustrates the explanatory power of each to account for the overall differences between the mate selection preferences of men and women. Although this research area often has been interpreted as providing evidence for evolved dispositions, a reanalysis of D. M. Buss’s (1989) study of sex differences in the attributes valued in potential mates in 37 cultures yielded cross-cultural variation that supports the social structural account of sex differences in mate preferences. [SOD]

Edwards, A. T. (1997). Let's stop ignoring our gay and lesbian students. Educational Leadership, 54, 68-70. The author works in Stratford, Connecticut, where they are working to break the silence of homosexuality and provide a safe, supportive climate that includes all students. Part of their work includes supporting parents seeking understanding, helping students find allies, and providing an accepting school environment

Edwards, W. J. (1996). Operating within the mainstream: Coping and adjustment among a sample of homosexual youths. Deviant Behavior, 17 (2), 229-251. A sample (N=37) of African American adolescent homosexual males was administered a questionnaire that focused on four areas of social psychological functioning (self-identity, family relation, school-work relations, and social adjustment). The findings contradicted several past studies that reported in general that homosexual males experience crippling cognitive dissonance. Even with the existence of homophobia in the society, the adolescents were found to possess an adequate social psychological attitude and survival skills. The sampled adolescents reported being comfortable with their sexual orientation even though the majority of them had not disclosed their homosexuality. The respondents reported how they managed self-presentation among heterosexual persons. The adolescents appeared well-adjusted and stable in their social functioning and disagreed with the idea that they needed professional counseling.

Edwards, W. J. (1996). A sociological analysis of an invisible minority group: Male adolescent homosexuals. Youth and Society, 27 (3), 334-355. This article examines the following areas of 37 Black male adolescents (age range: 16-21): self-identity, family relation, school/work relations, and social adjustment. Information about these areas was collected by using a Likert-type questionnaire that required the respondents to select the answers true or false. A majority of the respondents were comfortable with their sexual identity, although all of them were passing as heterosexuals. A sexual history of the respondents is presented. Even though the respondents understand their sexual minority status, it has not deterred the development of a positive and well-integrated self-perception.

Einhorn, L., & Poglar, M. (1994). HIV-risk behavior among lesbians and bisexual women. AIDS Education and Prevention, 514-523. Although limited available data suggest that AIDS is currently less common among lesbians than among heterosexual women, this study suggests considerable HIV-risk behavior among our sample of lesbians and bisexual women. In addition, a majority of respondents, including women at risk, do not use safer-sex practices.

Elia, J. P. (1994). Homophobia in high school: A problem in need of a resolution. High School Journal, 77 (1-2), 177-185. The purposes of this article are to: (1) define and discuss various forms of homophobia in the high school environment; (2) explore the ways in which homophobia negatively influences all high school students; and (3) propose actions to help combat homophobia and lessen its magnitude in the schools and, ultimately, throughout society. This article is an effort to continue both the dialogue about this serious problem as well as to assist with the herculean task of creating safe, equitable, and supportive schools.

Ellis-Stoess, L. (1996). Tolerating tolerance in the classroom. Journal of Law and Education, 25, 181-189. Homosexuality is a highly emotional issue, and people are divided as to whether discussions about it have a place in the classroom. This article examines several court battles that epitomize the arguments of parents and educators. The purpose of this discussion is to guide educators through this controversial subject and diffuse the potential for turmoil in the school system.

Epstein, D. (1997). Boyz' own stories: Masculinities and sexualities in schools. Gender and Education, 9 (1), 105-115. In this paper, the author draws on ethographic work to argue that schools are highly sexualized sites, within which struggles around sexuality are pervasive, of consuming interest and, at the same time, taboo. The author suggests that struggles around sexuality are intimately connected with struggles around gender, and that the explicit homophobia and implicit heterosexism found within schools derives from and feeds macho and misogynistic versions of masculinity. The paper suggests further that it is impossible to develop a full understanding of gender relations in schools without examining them in the context of compulsory heterosexuality.

Faulkner, A. H., & Cranston, K. (1998). Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. American Journal of Public Health, 88 (2), 262-266. This study documented risk behaviors among homosexually and bisexually experienced adolescents. Data were obtained from a random sample of high school students in Massachusetts. Violence, substance use, and suicide behaviors were compared between students with same-sex experience and those reporting only heterosexual contact. Differences in prevalence and standard errors of the differences were calculated. Students reporting same-sex contact were more likely to report fighting and victimization, frequent use of alcohol, other drug use, and recent suicidal behaviors. Students with same-sex experience may be at elevated risk of injury, disease, and death resulting from violence, substance abuse, and suicidal behaviors.

Ferraro, F. R., & Dukart, A. (1998). Cognitive inhibition in individuals prone to homophobia. Journal of Clinical Psychology, 54, (2), 155-162. Individuals scoring either High, Medium, or Low on the Homosexism Short-Form Scale (Hansen, 1982) made speeded decisions to neutral (N), mildly provocative (MP), or very provocative (VP) statements regarding issues related to homophobia. These three groups did not differ on age, education, reading rate, or vocabulary ability. It was predicted that individuals High in homophobia would produce faster reaction times to the VP sentences than those individuals scoring Medium or Low in homophobia. Results indicated the opposite pattern. Individuals scoring High in homophobia actually had slower reaction times to VP sentences than did either the Medium or Low homophobia individuals. Results are discussed within an inhibitory framework related to the High homophobia individuals’ overall homophobia schema.

Fikar, C. R. (1992). The gay pediatrician: A report. Journal of Homosexuality, 23, (3), 53-63. Since no articles in the medical literature could be found dealing with the subject of the pediatrician, a complete bibliographic search was conducted in order to find information about gay health professional. Using both manual and computerized methods of access to information in many data bases, much pertinent material was found. Reports were accessed which demonstrated that gay pediatricians most certainly exist and that, in addition to their standard role in pediatric and adolescent medicine, they have special and unique contributions to make to the care or our nation’s 2.9 million gay youth. Gay pediatricians need to be accepted as valuable professionals by peers and by society. Whenever possible, gay pediatricians need to act as role models to our gay youth. Pediatricians who happen to be gay have much to contribute to medicine.

Fontaine, J. H. (1998). Evidencing a need: School counselor's experience with gay and lesbian students. Professional School Counseling, 1 (3), 8-14. The study presented here seeks to identify the extent of contact school counselors have had with homosexual youth. Data were collected from K-12 counselors because it was believed that counseling needs can exist at any grade level. The study also includes data collected regarding current school environments and policies toward both racial and sexual minorities. School counselors’ knowledge about homosexual issues was also surveyed. Information was also collected on issues of professional development, that is, how counselors acquired their knowledge of homosexuality and what they perceived as resources that would be helpful to them and other school personnel in expanding their knowledge.

Fontaine, J. H. & Hammond, N. L. (1996). Counseling issues with gay and lesbian adolescents. Adolescence, 31 (124), 817-830. Few resources are available to counselors working with lesbian and gay adolescents. This article seeks to bridge the gulf between the life experiences of these teens and those of the counselor by providing information on sexual identity formation, increased mental health risk factors for gay and lesbian youth, coming out issues, and barriers to supportive interventions (given the hidden nature of much of this population within the schools and the world at large). Specific suggestions regarding how mental health counselors can assist these adolescents are provided.

Franke, R., & Leary, M. R. (1991). Disclosure of sexual orientation by lesbians and gay men: A comparison of private and public processes. Journal of Social and Clinical Psychology, 10 (3), 262-269. Analyses of the “coming out” process posit two distinct mediators of the willingness to disclose one’s homosexuality to others. Whereas some analyses focus on the individual’s self-acceptance of his or her sexual orientation, others implicate gays’ concerns with others’ reactions to such disclosures. This study tested the efficacy of these models. One hundred and eighty-four lesbians and gay men completed a questionnaires that included, among other things, two measures of openness regarding their sexual orientation. On both indices, subjects’ concerns with others’ evaluations predicted substantially more of the variance in openness than the degree to which they accepted their own sexuality.

Friedman, R. C., & Downey, J. (1993). Neurobiology and sexual orientation: Current relationships. Journal of Neuropsychiatry, 5, 131-153. Despite great progress in the neurosciences, or understanding of the determinants of sexual orientation is incomplete. The authors review for the clinician/neuropsychiatrist studies pertaining to the formation of sexual orientation in the following areas: hormone effects on sexual behavior (animal and human); the complicated relationship between gender identity, gender role, and sexual orientation in humans; cross-cultural studies of homosexuality; behavioral observations in psuedohermaphrodites and offspring of mothers treated with hormones during pregnancy; brain studies of homosexual and heterosexual individuals; and genetic studies. The authors conclude that human sexual orientation is complex and diversely experienced and that a biopsychosocial model best fits the current state of knowledge. [SOD]

Frieman, B. B., O'Hara, H., & Settel, J. (1996). What heterosexual teachers need to know about homosexuality. Childhood Education, 73, 40-42. The authors give a brief summary of current thinking on the development of homosexuality. They then describe what life is like for the gay student in elementary school and what teachers can do to make a positive difference in these student’s lives.

Garnets, L., Herek, G. M, & Levy, B. (1990). Violence and victimization of lesbians and gay men: Mental health consequences. Journal of Interpersonal Violence, 5 (3), 366-383. This article describes some of the major psychosocial challenges faced by lesbians and gay male survivors of hate crimes, their significant others, and the gay community as a whole. When an individual is attacked because she or he is perceived to be gay, the negative mental health consequences of victimization converge with those resulting from societal heterosexism to create a unique set of problems. Such victimization represents a crisis for the individual, creating opportunities for growth as well as risks for impairment. The principal risk associated with anti-gay victimization is that the survivor’s homosexuality becomes directly linked to her or his newly heightened sense of vulnerability. The problems faced by lesbian and gay male victims of sexual assault, and the psychological impact of verbal abuse also are discussed. Suggestions are offered to assist practitioners in helping the survivors to anti-gay crimes.

Garofalo, R., Wolf, R. C., Kessel, S., Palfrey, J., & DuRant, R.H. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics,101 (5), 895-902. This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. Students from public high schools in Massachusetts (4159 9th to 12th graders) were used. A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Heath risk and problem behaviors were analyzed comparing GLB youth and their peers. GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.

Garofalo, R., Wolf, R. C., Wissow, L. S., Woods, E. R., Goodman, E. (1999). Sexual Orientation and risk of suicide attempts among a representative sample of youth. Archives of Pediatric Adolescent Medicine 153 (5), 487-493. This article examines whether sexual orientation is an independent risk factor for reported suicide attempts. Data were obtained from the Massachusetts 1995 Centers for Disease Control and Prevention Youth Risk Behavior Survey, which included a question on sexual orientation. Ten drug use, 5 sexual behavior, and 5 violence/victimization variables chosen a priori were assessed as possible mediating variables.

Gerstel, C. J., Feraios, A. J., & Herdt, G. (1989). Widening circles: An ethnographic profile of a youth group. Journal of Homosexuality, 17 (1-2), 75-92. This article introduces work-in-progress on the ethnography of a gay and lesbian youth group in Chicago. The surrounding neighborhood is sketched and aspects of the supporting agency, within which the group functions, are described. Both are seen as contributing contexts for the coming out process here. The youth group is described in part, including the age, ethnicity, and related factors of its composition. Youth are found to be involved in a process of dual socialization entailing roles and knowledge in the gay and straight normative communities.

Ginsberg, R. W. (1998). Silenced voices within our schools. Initiatives, 58 (3), 1-15. In the course of teaching sociology for four semesters at a New England college, the author had three students (two male, one female) who used their term papers to come out to their teacher. The author describes why researching gays/lesbians and their school experience is necessary, and why doing so through the voices of gay/lesbian students is essential.

Gold, R. S., & Skinner, M. J. (1992). Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS, 6, 1021-1030. In structured interviews, gay men aged 15-21 years were asked to recall two sexual encounters from the preceding 6 months: one in which they had had unprotected anal intercourse (“unsafe” encounter) and one in which they had resisted a strong temptation to have unprotected intercourse (“safe” encounter). We studied both types of encounter to enable identification of situational variables distinguishing between them in order to investigate (1) the types of justifications, if any, that young gay men give themselves at the time they make the decision to have unprotected anal intercourse and (2) the types of occasion on which they are most at risk of having unprotected intercourse. The first two factors that emerged from a Factor Analysis of the self-justification data (“unsafe” encounter, n=219) involved, respectively, high-risk behavior in response to a negative mood state and inferring from perceptible characteristics that the partner was unlikely to be infected. The most commonly reported self-justification was this latter type. In respondents recalling both encounters (n=115), sexual desires, mood, communication, and use of “dirty talk” distinguished between the encounters. In contrast, type of partner, consumption of alcohol or drugs, desire for excitement, and use of pornography did not. Results are discussed in relation to those obtained in our earlier study of older gay men. Young gay men appear to be more single-minded about what they want to do sexually, and more likely to infer from perceptible characteristics that their partner is unlikely to be infected. In young gay men, a negative mood state is associated with unsafe sex, an opposite finding to that obtained with older gay men. The results also suggest the possible importance of failure to communicate about desires concerning safe sex and the use of “dirty talk;” these may help to facilitate the occurrence of unsafe sex.

Good, T. L. (Ed.) (1999). Non-subject matter outcomes of schooling. The Elementary School Teacher, 99 (5), 383-519. A special issue on nonsubject-matter outcomes of schooling. Articles discuss fifth- and seventh-grade girls’ decisions about participation in physical activity, a broader agenda for school reform, an embedded classroom approach to preventing high-risk behaviors among preadolescents, service-learning, self-regulation in democratic communities, teachers’ moral authority in classrooms and gender, and understanding diversity and promoting tolerance with regard to gay, lesbian, and bisexual youth in schools.

Green, R., Roberts, C. W., Williams, K., Goodman, M. et al (1987). Specific cross gender behaviour in boyhood and later homosexual orientation. British Journal of Psychiatry, 151, 84-88. Data from a group of males aged 13 to 23, who as children exhibited extensive cross-gender behavior, was analyzed. In boyhood they frequently played with dress-up dolls, role-played as females, dressed in girls clothes, stated the wish to be girls, primarily had girls as friends, and avoided rough-and-tumble play. The majority of the group evolved a bisexual or homosexual orientation; two types of behavior, boyhood doll play and female role-playing, were found to be associated with later homosexual orientation. The findings suggest developmental associations between specific types of boyhood cross-gender behavior and the objects of later sexual arousal.

Greene, J. M., Ennett, S. T., & Ringwalt, C. L. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. American Journal of Public Health, 89, (9), 1406-1409. A nationally representative sample of shelter youths and a multi-city sample of street youths were interviewed to examine the prevalence and correlates of survival sex among runaway and homeless youths. Approximately 28% of street youth and 10% of shelter youths reported having practiced in survival sex, which was associated with age, days away from home, victimization, criminal behaviors, substance use, suicide attempts, sexually transmitted disease, and pregnancy. Intensive and ongoing services are needed to provide resources and residential assistance to enable runaway and homeless youths to avoid survival sex, which is associated with many problem behaviors.

Griffin, P. (1994). Homophobia in sport: Addressing the needs of lesbian and gay high school athletes. High School Journal, 77 (1-2), 80-87. The purpose of this article is to describe some unique aspects of heterosexism and homophobia as they affect lesbian and gay athletes on high school sports teams. These include: (a) what accounts for the intense homophobia in athletics? (b)How does homophobia affect gay male and lesbian athletes? (c) What can high schools do to address homophobia in athletics?

Grossman, A. H. (1997). Growing up with a "spoiled identity": Lesbian, gay, and bisexual youth at risk. Journal of Gay and Lesbian Social Services, 6 (3), 45-56. Being a lesbian, gay or bisexual youth means having the stigma of homosexuality or bisexuality. A stigma is anything that discredits an individual and leads to one being assigned a spoiled identity. With reference to lesbian, gay and bisexual youth, the stigma is considered a blemish on one’s character that often leads to stereotyping and stigmatization. This homophobia puts many lesbian, gay and bisexual youth at risk for suicide, chemical abuse, dropping out of school, verbal and physical abuse, homelessness, prostitution, HIV infection, and psychosocial developmental delays. Approaches and strategies for working with lesbian, gay and bisexual youth are suggested and trends and issues about homosexuality in the United States, with a potential impact on lesbian, gay and bisexual youth, are discussed.

Grossman, A. H. (1995). Until there is acceptance. Journal of Physical Education, Recreation, and Dance, April, 47-48. Until there is acceptance of lesbian, gay, and bisexual youth by mainstream institutions, there is a need for special services. Recreation and social activities empower gay and lesbian youth to overcome the shame and self-hatred society places on them.

Grossman, A. H. (1992). Inclusion, not exclusion: Recreation service delivery to lesbian, gay, and bisexual youth. Journal of Physical Education, Recreation, and Dance, 63, 45-47. Prejudice and stigmatization experienced by lesbian, gay, and bisexual youth, the resulting isolation of these youth, and approaches that recreation and education professionals can use to create nonthreatening, supportive environments that are inclusive of lesbian, gay, and bisexual youth are discussed in this article.

Grossman, A. H., & Kerner, M. S. (1998). Self-esteem and supportiveness as predictors of emotional distress in gay male and lesbian youth. Journal of Homosexuality, 32 (2), 25-39. Many gay male and lesbian youth experience isolation, self-hatred, and other emotional stressors related to harassment and abuse from peers and adults, leading to risk factors associated with alcohol and substance abuse, suicide, prostitution, running away, and school problems. Research findings have indicated that high levels of self-esteem and social supports may moderate gay-identified stressors. The current study examined self-esteem and satisfaction with supportiveness as predictors of emotional distress in a sample of 90 self-identified urban gay male and lesbian youth. The sample of 58 gay male and 32 lesbian youth (ages 14 to 21 years) were predominately black and Latino/a. Findings indicated self-esteem as a predictor of moderate strength for emotional distress for the total and male samples; however, it proved to be a strong predictor for the female sample. Satisfaction with supportiveness, however, proved to be insignificant in explaining the variance of emotional distress. As the latter is contrary to anecdotal evidence, it is recommended that future studies examine satisfaction with specific types of supportiveness rather than the global measure used in the current study.

Grubb, P. F. (1987). Reading about homosexuality. Journal of Homosexuality, 13 (2-3), 121-135. A study was conducted to access the importance of reading about experiences on homosexuality for adolescents and post-adolescents. Although no conclusive evidence could be found to link their reading experience to later experiences as a means of instigating change or providing role models, the author suggests that reading materials can be influential.

Gwadz, M., & Rotheram-Borus, M. J. (1992). Tracking high-risk adolescents longitudinally. AIDS Education and Prevention, Supplement, 69-82. Longitudinal tracking methods rarely have been documented. A discussion is provided here of tracking methods and strategies used in assessing the effectiveness of an AIDS prevention intervention with high-risk adolescents over four years. We demonstrated an ability to follow 92% of a sample of unstable youths in a difficult urban environment. Successful recontacting of youths depended on the structure of the project in the recruitment phases, strategic choice of interviewers, a cost-effective payment schedule and other motivators, knowledge of appropriate social service agencies that could provide information on youths, and methods to elicit cooperation. Confidentiality and other ethical issues are discussed.

Hammelman, T. L. (1993). Gay and lesbian youth: Contributing factors to serious attempts or considerations of suicide. Journal of Gay and Lesbian Psychotherapy, 2 (1), 77-89. This is a study of gay and lesbian youths’ tendencies for suicide and the extent to which these tendencies are influenced by sexual orientation, violence, age, substance abuse, physical or emotional abuse, family rejection, or gender. Based on a sample of 48 respondents, nearly one-half seriously considered suicide while one-third actually attempted suicide. Close to three-quarters of this population cited sexual orientation as some or most of the reason for their suicide consideration or attempt with the majority revealing that they had done so at age 17 or before. Fifty percent or more of those who (1) had a substance abuse problem, (2) were physically or emotionally abused, or (3) experienced family rejection, reported that sexual orientation was the main reason for these problems. These results are clinically significant for therapists who work with this population. The mere existence of suicide considerations or attempts because of sexual orientation calls for a proactive stance which includes conducting a thorough psycho-social assessment, performing crisis intervention and assisting youth to increase their coping mechanisms.

Harrington-Lueker, D. (1996). Surviving the gay-rights furor. The Education Digest, 62, 56-59. This article describes some incidences when school districts struggled with addressing gay and lesbian issues in public schools. Those who have wrestled with homosexuality and the public schools off this advice: (1) don’t stifle discussion, (2) pay attention to your policies and procedures, (3) anticipate problem areas, and get your community involved, (4) vote and get on with it, and (5) don’t rush into making new policy, you might not need one.

Harry, J. (1993). Being out: A general model. Journal of Homosexuality, 26 (1), 25-39. It is argued that being out to heterosexuals is a result of structural and individual conditions permitting one to be out, rather that a late stage in a process of coming out. The concept of coming out is largely applicable to the transitions to adulthood while having little applicability to adult homosexuals. Data on 1,556 gay men are presented showing the relationships of being out to heterosexuals with income, type of occupation, area of residence, sexual orientation of friends, and individual non-conformity. These data show that much variation in being out can be explained by these factors rather than a stage of the coming out process.

Herek, G. M. (1989). Hate crimes against lesbians and gay men. American Psychologist, 44 (6), 948-955. Antigay hate crimes (words or actions that are intended to harm or intimidate individuals because they are lesbian or gay) constitute a serious national problem. In recent surveys, as many as 92% of lesbians and gay men report that they have been the targets of antigay verbal abuse or threats, and as many as 24% report physical attacks because of their sexual orientation. Assaults may have increased in frequency during the last few years, with many incidents now including spoken references to the acquired immunodeficiency syndrome by the assailants. Trends cannot be assessed, however, because most antigay hate crimes are never reported and no comprehensive national surveys of antigay victimization have been conducted. Suggestions are offered for research and policy.

Herek, G. M., & Capitanio, J. P. (1996). "Some of my best friends": Intergroup contact, concealable stigma, and heterosexuals' attitudes toward gay men and lesbians. Personality and Social Psychology Bulletin, 22 (4), 412-424. In a two-wave national telephone survey, a probability sample of English-speaking adults indicated their attitudes toward gay men at Wave I (1990-1991; n=538) and toward both gay men and lesbians approximately one year later (n=328 at Wave II). At Wave I, heterosexuals reporting interpersonal contact (31.3%) manifested more positive attitudes toward gay men than those without contact. Their attitudes were more favorable to the extent that they reported more relationships, closer relationships, and having received direct disclosure about another’s homosexuality. At Wave II, these findings were generally replicated for attitudes toward lesbians as well as gay men. Cross-wave analyses suggest a reciprocal relationship between contact and attitudes. Theoretical and policy implications of the results are discussed, with special attention to the role of interpersonal disclosure in reducing stigma based on a concealable status.

Hershberger, S. L., & D’Augelli, A. R. (1995). The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Developmental Psychology, 31 (1), 65-74. Lesbian, gay, and bisexual youths 15 to 21 years old were studied to determine the impact of verbal abuse, threat of attacks, and assault on their mental health, including suicide. Family support and self-acceptance were hypothesized to act as mediators of the victimization and mental health-suicide relation. Structural equation modeling revealed that in addition to a direct effect of victimization on mental health, family support and self-acceptance in concert mediated the victimization and mental health relation. Victimization was not directly related to suicide. Victimization interacted with family support to influence mental health, but only for low levels of victimization.

Hershberger, S. L., Pilkington, N. W., & D'Augelli, A. R. (1997). Predictors of suicide attempts among gay, lesbian, and bisexual youth. Journal of Adolescent Research, 12 (4), 477-497. This research identified predictors of past suicide attempts in 194 lesbian, gay, and bisexual youth, 15 through 21 years of age, who attended social and recreational groups in urban community settings. In comparison to youth who made no suicide attempts, attempters reported that they had disclosed more completely their sexual orientation to others, had lost more friends because of their disclosures, and had experienced more victimization due to their sexual orientation. Suicide attempters had lower self-esteem and acknowledged more mental health problems. The loss of friends due to youth’s sexual orientation, and current suicidal ideation were among the strongest predictors of suicide attempts. Youth who reported early awareness of their sexual orientation, disclosure to family and friends, peer rejection, and victimization based on their sexual orientation may be at risk for mental health problems.

Hetrick, E. S., & Martin, A. D. (1987). Developmental issues and their resolution for gay and lesbian adolescents. Journal of Homosexuality, 14 (1-2), 25-43. The primary task for homosexually oriented adolescents is adjustment to a socially stigmatized role. Although the individual homosexual adolescent reacts with diversity and great resilience to societal pressures, most pass through a turbulent period that carries the risk of maladaptive behaviors that may affect adult performance. Despite individual variation, certain issues have been found to concern most homosexual adolescents. Empirical data from the Institute for the Protection of Lesbian and Gay Youth, Inc. in New York City suggests that isolation, family violence, educational issues, emotional stresses, shelter, and sexual abuse are the main concerns of youth entering the program. If not resolved, the social, cognitive, and emotional isolation may extend into adulthood, and anxiety, depressive symptoms, alienation, self-hatred, and demoralization may result. In a non-threatening supportive environment that provides accurate information and appropriate peer and adult role models, many of the concerns are alleviated and internalized negative attitudes are either modified or prevented from developing. The authors discuss the effects of prejudice and the impact of negative societal attitudes on the developing social and personal identities of homosexual youths. [SOD]

Holtzen, D. W., & Agresti, A. A. (1990). Parental responses to gay and lesbian children: Differences in homophobia, self-esteem, and sex-role stereotyping. Journal of Social and Clinical Psychology, 9 (3), 390-399. This study investigated parental reactions to knowledge of a child’s gay or lesbian sexuality. Parents (N=55) of gay and lesbian children completed several measurements measuring homophobia, self-esteem, attitudes toward women, and social behavior. Parents with high homophobia were significantly different than parents with low homophobia in that homophobia scores correlated negatively with all measures. Also, the amount of time a parent has known of his or her child’s sexuality in combination with the parents sex-role stereotypes proved a good predictor of his or her homophobia score. Implications of these findings with regard to an understanding of homophobia are discussed, as well as the possible impact of homophobia on the self-esteem and the sex role attitudes of parents, and gay and lesbian children.

Holtzen, D. W., Kenny, M. E., & Mahalik, J. R. (1995). Contributions of parental attachment to gay or lesbian disclosure to parents and dysfunctional cognitive processes. Journal of Counseling Psychology, 42 (3), 350-355. This study examined the relationship among parental attachment, sexual self-disclosure to parents, and dysfunctional cognitions in a sample of 113 gay and lesbian adults. The results revealed that characteristics of secure attachment to mother and father were positively associated with disclosure to parents and length of time since disclosure, and they were negatively associated with self-reports of dysfunctional cognitions. These results suggest that attachment quality warrants further investigation as a factor that may facilitate disclosure to parents and reduce the risk for dysfunctional cognitions.

Hunter, J. (1990). Violence against lesbian an gay male youths. Journal of Interpersonal Violence, 5 (3), 295-300. This article documents the incidence of violent assaults toward lesbian and gay male youths and those youths suicidal behaviors. Data were obtained by reviewing charts for the first 500 youths seeking services in 1988 at the Hetrick-Martin Institute, a community-based agency serving lesbian and gay male adolescents in New York City. The adolescents, who range in age from 14 to 21 years were predominantly minority (35% Black, 46% Latino) and typically were referred by peers, media, schools, and emergency shelters. Of the youth, 41% in the sample reported having suffered violence from families, peers, or strangers; 46% of that violence was gay-related. These reports of violence occurred in conjunction with a high rate of suicide attempts; 41% of the girls and 34% of the boys who experienced violent assaults reported having attempted suicide. These alarming rates indicate the need for more systematic monitoring of violence toward and suicidal behavior among lesbian and gay male youths.

Hunter, J., & Schaecher, R. (1987). Stresses on lesbian and gay adolescents in schools. Social Work in Education, 9 (3), 180-190. An awareness of homosexual orientation often emerges in students during their high school years. A significant portion of these self-identified youngsters experience unique stresses that the school system needs to recognize and address in an affirmative manner. The authors provide an overview of the problems and briefly describe the role of the school social worker.

Jennings, K. (1989). Opening closets and minds. Independent School, Winter, 23-29. The author discusses his experiences coming out to his school community. Included in this discussion are the reasons he decided to be open, and the problems, pressures and contrasts he faced. Lastly, the impact of his disclosure on his students, both gay and straight, is addressed.

Johnson, D. (1996). The developmental experiences of gay/lesbian youth. Journal of College Admission, 152-153, 38-41. The author discusses several issues gay and lesbian youth face while attempting to form an identity they have been taught to hate. The process is usually accompanied, according to the author, by a profound sense of isolation and alienation and the youth respond in one of two ways: 1) by being the best little boy/girl on the face of the earth, or becoming 2) the drop-out. The author concludes with suggestions for how the concerned school counselor or teacher can become an in ally to the gay/lesbian students around them. [SOD]

Jordan, K. M., & Deluty, R. H. (1998). Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem, and social support. Journal of Homosexuality, 35 (2), 41-63. The present study investigated relations between lesbians’ disclosure of their sexual orientation and psychological adjustment. The 499 participants responded to a questionnaire assessing level of self-disclosure, sources of social support, forms of socializing, self-description of sexual orientation, and length of self-identification as a lesbian. The more widely a woman disclosed her sexual orientation the less anxiety, more positive affectivity, and greater self-esteem she reported. Degree of disclosure to family, gay and lesbian straight friends, and co-workers was related to overall level of social support, with those who more widely disclosed reporting greater levels of support. Participants who more widely disclosed their sexual orientation were less likely to engage in anonymous socializing, had a larger percentage of lesbian friends, and were more involved in the gay and lesbian community. Path analyses revealed a mediating effect of social reactions (both initial and current) on the relation between identity development and self-disclosure. [SOD]

Katz, M. H., McFarland, W., Guillin, V., Fenstersheib, M., Shaw, M., Kellogg,T., Lemp, G. F., MacKellar, D., & Valleroy, L. A. (1998). Continuing high prevalence of HIV and risk behaviors among young men who have sex with men: The young men’s survey in the San Francisco Bay Area in 1992 to 1993 and in 1994 to 1995. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 19, 178-181. Several recent studies have shown high rates of HIV infection and risk behavior among young men who have sex with men (MSM). To assess the direction of the epidemic in this population, we replicated a venue-based study performed in the San Francisco Bay Area during 1992 and 1993. From May 1994 to September 1995, we surveyed 675 MSM aged between 17 and 22. After statistical adjustment for age, ethnicity, residence, and site of recruitment, seroprevalence did not change significantly between the 1992 to 1993 (8.4%) and the 1994 to 1995 (6.7%) surveys. Similarly, no significant changes were found in the rates during the previous 6 months of unprotected receptive anal intercourse (23.4% versus 24.9%), injection drug use (8.0% versus 7.8%), or needle sharing among injection drug users (56.3% versus 64.5%) between the two surveys. Despite the increased attention that the problem of high risk behavior among young MSM has received, effective prevention interventions for MSM are needed as profoundly now as they had been several years ago.

Kelly, T. F., & Langsang, D. (1999). Pediatric residency training and the needs of gay, lesbian, and bisexual youth. Journal of the Gay and Lesbian Medical Association, 3, (1), 5-9. This study surveys the education of pediatric residents about the needs of gay, lesbian, and bisexual (GLB) youth. The report measures the extent to which such training is considered valuable by those responsible for its administration and it evaluates the awareness of community referrals for GLB youth. U.S. pediatric residency directors and chief residents were surveyed using a questionnaire designed by the authors. Percentage tabulation of the questions was performed. Chi-square analysis of two questions was done to determine if there was an association between the responses given and whether or not a respondent was from a program that offered training to their residents. Over half of the respondents indicated that their programs offered training in the care of GLB youth. This increased to over three fourths when those respondents who indicated that their program was planning such training efforts were included. There was a broad distribution in the form and prevalence of training techniques. Over 90% of the respondents indicated that they valued the inclusion of GLB youth issues into residency curricula. A lesser majority indicated an awareness of community referrals for GLB youth. A large majority of pediatric residencies are either training their residents about the needs of GLB youth or are developing such training opportunities. The form and extent of the training varies widely. As such, the continued development of educational approaches and evaluation measures are encouraged.

Kennedy, M. B., Scarlett, M. I., Duerr, A. C., & Chu, S. Y. (1995). Assessing HIV risk among women who have sex with women: Scientific and communication issues. Journal of the American Medical Women’s Association, 50, (3&4), 103-107. Data on human immunodeficiency virus (HIV) risk faced by women who have sex with women (WSW) are scarce. The biologic risk of female-to-female transmission is not known. Several surveys have reported that certain groups of WSW engage in behaviors that put that at risk for HIV infection, such as unprotected sex or sharing sex toys with women, and injection drug use. WSW may also be at risk for HIV through use of unscreened semen from sources other than sperm banks. An evaluation of HIV risk behaviors among WSW has been hampered by methodological issues, such as lack of data about the extent of the population, the use of standard definitions in research, and the design of data collection instruments. HIV prevention efforts have been hampered by communication issues, such as what “safer sex” means to this population and difficulties in interactions with health care providers. Prevention interventions for this population must address behaviors that put WSW at risk for HIV infection, including injection drug use and unprotected penile sex. At the same time, the possibility of sexual transmission of HIV via female-to-female sex should not be discounted. Health providers should understand that sexual identity does not necessarily predict sexual behavior and should not make any assumptions regarding HIV risk based on self-reported or presumed sexual identity.

Kielwasser, A. P., & Wolf, M. A. (1994). Silence, difference, and annihilation: Understanding the impact of mediated heterosexism on high school students. High School Journal, 77 (1-2), 58-79. The evidence of homophobia and heterosexism can be found throughout our society. Uniquely, lesbian and gay youth face rejection and isolation not only from society in general, but also from their parents and peers. This article provides a theoretical context for understanding the impact of mediated heterosexism on lesbian and gay adolescents. Specifically, this essay draws upon three social-psychological concepts: the distinctiveness postulate, symbolic annihilation, and spiral of silence theory. In uniting these concepts, the authors theoretically situate the problem of lesbian and gay representation within a seamless ideological field that encompasses both elite and popular culture.

Kissen, R. M. (1993). Listening to gay and lesbian teenagers. Teaching Education, 5, 57-67. Describes the answers to a questionnaire sent to lesbian and gay support groups around the country asking how it felt to be gay in high school, and how young people thought teachers and counselors could make their classrooms more comfortable for gay and lesbian students. Forty-four responses came from young people who attended both public and parochial schools in 17 states and one foreign country. Thirty-seven of the participants were male. Most were not know to peers or adults as gay in school. Responses revealed that in most cases homosexuality was not discussed (or discussed positively) in school. Eighteen had no good memories of high school and most only remembered positive moments outside of school. The ex-students gave suggestions on how teachers could make life better for gay students, including being more supportive, taking them seriously, and treating them the same as other students. They also urged gay teachers to come out. The article ends with a discussion on preparing teachers to deal with sexual diversity by having gay and lesbian guest speakers and interrupting homophobic behavior. [SOD]

Kourany, R. F. C. (1987). Suicide among homosexual adolescents. Journal of Homosexuality, 13 (4), 111-117. Little attention has been given in the professional literature to suicide among homosexual adolescents. Sixty-six adolescent psychiatrists responded to a questionnaire on the subject. Results from this survey suggest that many experts are not working with homosexual adolescents. On the other hand, the majority of those treating them considered them to be at higher risk for suicide and agreed that their suicidal gestures were more severe than those of other adolescents.

Kruks, G. (1991). Gay and lesbian homeless/street youth: Special issues and concerns. Journal of Adolescent Health, 12, 515-518. Data on homeless and runaway youth were collected through a consortium of agencies, including one that provides services to a high percentage of gay-, lesbian-, and bisexual-identified youth. Gay and bisexual male youth appear to be at increased risk for both homelessness and suicide. Gay male street youth may have been forced out of their homes because of their sexual orientation, and are more likely to engage in survival sex (prostitution) than their nongay male counterparts. In one sample, 53% of gay-identified street youths had attempted suicide, compared with 32% of a cohort of street youths that included both gay and nongay street youths. Prejudice, discrimination, and homophobia are still rampant in society today; these factor contribute to a multiplicity of problems that face the young person who is gay.

Krysiak, G. J. (1987). A very silent and gay minority. School Counselor, 34 (4), 304-307. The author of this article appeals to counselors of adolescents to raise their consciousness to the real probability that they are working with gay and lesbian adolescents whose identity is likely hidden, whose lives are stressful, and whose needs are real and should be addressed by school counselors. It is the author’s intent to suggest some special considerations that might be given the gay or lesbian high school student.

LaFontaine, L. (1994). Quality schools for gay and lesbian youth: Lifting the cloak of silence. Journal of Reality Therapy, 14 (1), 26-28. Acknowledgement of the needs of gay and lesbian youth is an issue that merits the attention of those who support a Quality School approach to education. The author discusses these issues in terms of reality/control theory, a philosophy based on a recognition of the basic needs of the individual and the importance of fulfilling these needs for individuals to function in a productive and effective manner.

Lampela, L. (1996). Concerns of gay and lesbian caucuses with art, education, and art education. Art Education, 49, 20-24. Groups devoted to the greater visibility of lesbian and gay concerns have emerged within learned societies and national organizations in the field of education and art. This article examines three topics in order to focus attention on the need to establish a gay and lesbian caucus within the National Art Education Association (NAEA). The three topics include: traditional attitudes toward homosexuality in society and the schools, common concerns of gay and lesbian caucuses in the fields of art and education, and the objectives in the proposed constitution of the Lesbian/Gay/Bisexual Issues Caucus of the NAEA. As a follow up, this article provides interested art teachers with strategies to address issues of lesbian and gay concerns in the art classroom.

Leck, G. M. (1994). Politics of adolescent sexual identity and queer responses. High School Journal, 77 (1-2), 186-192. The author discusses both the historical and contemporary politics of both considering and teaching adolescents as sexual beings. The author also talks of gay and lesbian youth as the new crusaders for sexuality freedom in public schools.

Lemp, G. F., Hirozawa, A. M., Givertz, D., Nieri, G. N., Anderson, L., Lindegren, M. L., Janssen, R. S., & Katz, M. (1994). Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. Journal of the American Medical Association, 272, (6), 449-454. A survey of 435 young homosexual and bisexual men (17 to 22 years old) sampled from public venues in San Francisco and Berkeley, CA (including street corners, dance clubs, bars, and parks) during 1992 and 1992 estimated the prevalence of human immunodeficiency virus (HIV) infection and risk behaviors. Participants were interviewed and blood specimens were drawn and tested for HIV, level of CD4+ T lymphocytes, and markers of hepatitis B and syphilis. The HIV seroprevalence was 9.4% (95% confidence interval, 6.8% to 12.6%). The prevalence of markers for hepatitis B was 19.8% (95% confidence interval, 16.1% to 23.9%), and that for syphilis was 1.0% (95% confidence interval, 0.3% to 2.4% ). The HIV seroprevalence was significantly higher among African-Americans (21.2%) than among other racial/ethnic groups (P=.002). Approximately one third (32.7%) of the participants reported unprotected anal intercourse, and 11.8% reported injecting drug use in the previous 6 months. At the time of interview, 70.0% of the HIV-infected men did not know that they were HIV seropositive, and only 22.5% were receiving medical care for HIV infection. The prevalence of HIV infection is high among this young population of homosexual and bisexual men, particularly among young African-American men. The high rates of HIV-related risk behaviors suggest a considerable risk for HIV transmission in this population. Prevention programs and health services need to be tailored to address the needs of a new generation of homosexual and bisexual men.

Lipkin, A. (1994). The case for a gay and lesbian curriculum. High School Journal, 77 (1-2), 95-107. The debate about New York's "Children of the Rainbow Curriculum" was a rallying point for public discourse about the nature of sexuality and families. This article talks about the importance of this discourse as well as the importance of including teaching about homosexuality in our public schools.

Lock, J. L, & Steiner, H. (1999). Relationships between sexual orientation and coping styles of gay, lesbian, and bisexual adolescents from a community high school. Journal of the Gay and Lesbian Medical Association, 3 (3), 77-82. Gay, lesbian, and bisexual (GLB) adolescents have been reported to be at increased risk for a variety of physical and emotional illnesses compared to heterosexual youths. Coping styles have been associated with health risks in a variety of physical and emotional illnesses. We report on the coping style of 106 self-identified GLB high school students from a total 1769 high school students who completed an anonymous health risk questionnaire that included specific questions related to coping style. We found that there was an overall significant effect of sexual orientation on coping style. In addition, both approach, and avoidant styles of coping were significantly greater in those who self-identified as GLB. We concluded that when compared to a community sample of self-identified heterosexual youth, GLB youth overall demonstrate high levels of coping behaviors in order to assist them with the stresses and difficulties associated with GLB status.

Lock, J. & Steiner, H. (1999). Gay, lesbian, and bisexual youth risks for emotional, physical, and social problems: Results from a community-based survey. Journal of the American Academy of Child and Adolescent Psychiatry 38 (3), 297-304. Health problems of gay, lesbian, and bisexual (GLB) youth are reported as differing from those of heterosexual youth. Increased depression, suicide, substance use, homelessness, and school drop-out have been reported. Most studies of GLB youth use clinical or convenience samples. The authors conducted a community school-based health survey that included an opportunity to self-identify as GLB.

Louderback, L. A., & Whitely, B. E., Jr. (1997). Perceived erotic value of homosexuality and sex-role attitudes as mediators of sex differences in heterosexual college students’ attitudes toward lesbians and gay men. The Journal of Sex Research, 34 (2), 175-182. Research on attitudes toward lesbians and gay men commonly shows that heterosexual women hold similar attitudes toward members of the two groups, whereas heterosexual men hold more negative attitudes toward gay men than toward lesbians. We tested the hypothesis that non reason for this sex difference is that heterosexual men attribute a high erotic value to lesbianism and that this erotic value ameliorates their attitudes toward lesbians. Fifty-eight male and 109 female heterosexual college students completed questionnaires that assessed their attitudes toward lesbians and gay men, the erotic value that they attributed to male and female homosexuality, and their sex-role attitudes. The sex differences in attitudes toward lesbians and gay men found in previous research were replicated and, as hypothesized, men attributed more erotic value to lesbianism than to male homosexuality, whereas women attributed low erotic value to both forms of sexuality. However, with perceived erotic value of homosexuality controlled, rating of gay men were similar to rating of lesbians for both male and female participants, although men’s rating of both groups were more negative than women’s. Controlling for sex-role attitudes removed this residual sex difference. We discuss possible sources of the heterosexual male eroticisation of lesbianism and implications of the gender belief system for understanding attitudes toward lesbians and gay men.

Loutzenheiser, L. W. (1996). How schools play "smear the queer". Feminist Teacher, 10, 59-64. In this era of conservative backlash, the fear of confronting the issue of homosexuality is, at least in part, a fear of the New Right. Schools, particularly because they serve children and are accountable to myriad interest groups, are as susceptible to these pressures as any institution. The author describes how gay and lesbian youth are being neglected by the public school system in terms of Smear the Queer, a game played at her own and many other elementary schools in which participants pile on top of the person with the ball. Generally, this person was perceived as weaker or less popular than the others.

MacKellar, D., Valleroy, L., Karon, J., Lemp, G., & Janssen, R. (1996). The Young Men’s Survey: Methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Reports, III, (Suppl. I), 138-144. Conducted in seven metropolitan areas in the Untied States, the Young Men’s Survey combines outreach techniques with standard methods of sample surveys to enumerate, sample, and estimate prevalence outcomes of a population of young men who frequent public venues and who have sex with other men. Venues included dance clubs, bars, and street locations. At sampled venues, young men are enumerated, consecutively approached, and offered enrollment if they are determined eligible. Young men who agree to participate in the Young Men’s Survey are interviewed, counseled, and tested for human immunodeficiency virus, hepatitis B, and syphilis in vans parked near sampled venues. The Young Men’s Survey provides data on the locations and times at which demographic and behavioral subgroups of young men who have sex with men may be targeted for prevention activities. Behaviors and psychosocial factors associated with human immunodeficiency virus infection can be used to design culturally relevant and age-specific prevention activities for young men who have sex with men.

Mallet, P., Apostolidis, T., & Paty, B. (1997). The development of gender schemata about heterosexual and homosexual others during adolescence. Journal of General Psychology, 124 (1), 91-104. Perceptions of heterosexual and homosexual individuals were investigated among 12-, 16-, and 20-year-old French adolescents. Participants described heterosexual and homosexual males and females with typical masculine and feminine personality traits. Overall, they perceived heterosexual males as having more masculine traits than homosexual males. The 16- and 20-year-olds perceived homosexual males as more feminine than heterosexual males, whereas the reverse was observed in 12-year-olds. Furthermore, the 12-year-olds perceived heterosexual females as more feminine than homosexual females, a difference that disappeared in the older age groups. Results support the view of early adolescence as a crucial period in the development of gender schemata about sexually significant others. [SOD]

Mallon, G. (1997). Entering into a collaborative search for meaning with gay and lesbian youth in out-of-home care: Empowerment-based model for training child welfare professionals. Child and Adolescent Social Work Journal, 14, (6), 427-444. Utilizing an empowerment-based approach, which incorporates self-identified gay and lesbian youths and openly gay and lesbian child welfare professionals as collaborative partners in the process, this article offers a model for training child welfare professionals to work more effectively with gay and lesbian youth in out-of-home care. This three hour training model empowers the gay and lesbian youth, whose voices have been subjugated, to emerge as the experts in training child welfare professionals to more competently and responsively address and meet their needs.

Mallon, G. (1992). Gay and no place to go: Assessing the needs of gay and lesbian adolescents in out-of-home care settings. Child Welfare, LXXI, (6), 547-556. Gay and lesbian adolescents, whether self-declared or in the throes of sexual identity struggles, are and have been in out-of-home care settings. Their placements are often negative experiences because their feelings of difference are frequently aggravated by the attitudes of those around them, including other children and some staff members. This article discusses factors that can help make placement a positive experience for these youth.

Mallon, G. (1992). Serving the needs of gay and lesbian youth in residential treatment centers. Residential Treatment for Children and Youth, 10, (2), 47-61. Stigmatization of the lesbian and gay adolescent and their lack of access to appropriate residential treatment settings has evolved from decades of fear, misinformation, and the mistaken belief that this population of youngsters should be able to “fit into” the existing youth services systems. Planning for the gay and lesbian adolescent in care presents unique challenges for residential treatment agencies. Education and training of staff, board members and other residents about issues pertaining to gay and lesbian adolescents and encouraging them to examine their own responses to homosexual orientation, can enhance opportunities for identifying, addressing, and serving the needs of this client group.

Marinoble, R. M. (1998). Homosexuality: A blind spot in the school mirror. Professional School Counseling, 1 (3), 4-7. This article focuses on the issues and challenges that confront school counselors in working with students who begin to exhibit a homosexual orientation during their school years. These include identity conflict, feelings of isolation and stigmatization, peer relationship problems, and family disruptions. Each of these difficulties is discussed in terms of how it may manifest itself, and possibly be aggravated, in the school setting.

Martin, H. P. (1991). The coming-out process for homosexuals. Hospital and Community Psychiatry, 42 (2), 158-162. Coming out is a core developmental process for homosexual persons that spans many years. It usually begins in childhood with feelings of being different and progresses through various stages, including acknowledgement of homosexuality, disclosure to others, acceptance of homosexual identity, experimentation and exploration, and intimacy. Ideally, the process ends in consolidation, a stage in which homosexuals no longer view themselves primarily in terms of sexual orientation. The author describes the various stages of the coming-out process and discusses the clinical implications for therapy with homosexual patients.

Martin, A. D., & Hetrick, E. S. (1988). The stigmatization of the gay and lesbian adolescent. Journal of Homosexuality, 15 (1-2), 163-183. Individual members of a stigmatized group must learn to cope with the intra- and interpersonal implications of the ideology specific to their group. For homosexually oriented adolescents, the psychological, emotional, and social consequences will probably involve ego-dystonic reactions, including, but not limited to coping strategies found in all stigmatized groups. The following discussion will center around the presenting problems of clients at a social service agency serving homosexually oriented adolescents. These include cognitive, social and emotional isolation, family issues, education, and sexual abuse.

Mathison, C. (1998). The invisible minority: Preparing teachers to meet the needs of gay an lesbian youth. Journal of Teacher Education, 49 (Mar-Apr), 151-155. Questions related to teacher educators’ responsibility to prepare future teachers to teach gay and lesbian students include: (1) what teacher behaviors most alienate gay and lesbian students? (2) what negative messages does the school/classroom social environment communicate? (3) what messages does the curriculum send? This article addresses all three of these questions.

McFarland, W.P. (1998). Gay, lesbian, and bisexual student suicide. Professional School Counseling, 1 (3), 26-29. Professional school counselors have the ethical duty to serve all students in their schools including gay, lesbian, and bisexual students. All professional school counselors need to understand why this hidden minority is at high risk for suicide in order to develop and implement interventions through a developmental guidance program. This article will explain the statistical profile of suicidal gay, lesbian, and bisexual youth; discuss the suicidal risk factors for this population; and propose preventive and responsive interventions for school counselors.

McLaren, P. (1994). Moral panic, schooling, and gay identity: Critical pedagogy and the politics of resistance. High School Journal, 77 (1-2), 157-168. Peter McLaren posits that we are living at a time in U.S. cultural history in which the autonomy and dignity of the human spirit is being threatened rather than exercised. This article talks about how this decidedly postmodern combination of extreme wakefulness and forgetfulness has helped create the contemporary moral panic surrounding sexuality.

McMillen, C. (1992). Sexual identity issues related to homosexuality in the residential treatment of adolescents. Residential Treatment for Children & Youth, 9, (2), 5-21. Sexual identity issues related to homosexuality are often of significant importance to adolescents in care. Sexual abuse histories, a possible over-representation of gay and lesbian adolescents in care and the dynamics of the group care environment all contribute to heighten the saliency. Policy and practice recommendations are offered for affirmatively handling these issues.

McNall, M., & Remafedi, G. (1999). Relationship of amphetamine and other substance use to unprotected intercourse among young men who have sex with men. Archives of Pediatric Adolescent Medicine, 153,1130-1135. This article analyzed trends in drug use and the relationship between drug use before or during sex and unprotected intercourse among a sample of young gay and bisexual men. Data were obtained from cross-sectional surveys of 9 annual cohorts. Respondents were 877 13- to 21-year-old gay and bisexual male volunteers. Trends in the use of substances before of during sex were analyzed. Univariate and multivariate measures of the association between substance use before or during sex and unprotected anal intercourse were calculated. Between 1994 and 1997, the use of marijuana, cocaine, amphetamines, and mean scores on a measure of overall drug use severity increased significantly in a sample of young gay and bisexual men. Significant univariate associations were found between drug use before or during sex and unprotected anal intercourse for the following substances: alcohol, marijuana, cocaine, amphetamines, barbiturates, heroin, LSD, volatile nitrates, tranquilizers, and methaqualone. In multivariate analyses, however, only cocaine use predicted failure to use condoms during anal intercourse. In conclusion, although only amphetamine and other drug use increased among gay and bisexual men, only cocaine use was a significant, independent predictor of the failure to use condoms during anal intercourse.

Mercier, L. R., & Berger, R. M. (1989). Social service needs of lesbian and gay adolescents: Telling it their way. Journal of Social Work and Human Sexuality, 8 (1), 75-95. Lesbian and gay adolescents begin to explore their social and sexual identities in environments which are generally unfavorable to the development of positive self-esteem. Little is known about how these adolescents face this challenge. This survey of lesbian and gay adolescents explores the nature and extent of their psychosocial problems and the persons and resources to whom they turn for help. Social service needs centered on the issues of identity management, depression, limited resources for getting help, and getting along with family members.

Meyenberger, B. (1999). Gender identity disorder in adolescence: Outcomes of psychotherapy. Adolescence, 34, (134), 305-313. Gender identity disorder (GID) is characterized by strong and persistent cross-gender identification and by persistent discomfort with one’s sex. This paper reviews reports of GID in which adolescent psychotherapy patients initially desired sex reassignment. In addition, four case studies of adolescents with GID, demonstrating different outcomes of psychotherapy, are presented. It is concluded that great caution must be exercised when treating adolescents with GID, and that sex reassignment must not be started before patients have reached eighteen years of age.

Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36 (March), 38-36. This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization. Minority stressors were conceptualized as: internalized homophobia; which relates to gay men’s direction of societal negative attitudes toward the self; stigma, which relates to expectations of rejection and discrimination; and actual experiences of discrimination and violence. The mental health effects of three minority stressors were tested in a community sample of 741 New York City gay men. The results supported minority stress hypotheses: each of the stressors had a significant independent association with a variety of mental health measures. Odds ratios suggested that men who had high levels of minority stress were twice as likely to suffer also from high levels of distress.

Miranda, J, & Storms, M. (1989). Psychological Adjustment of Lesbians and Gay Men. Journal of Counseling and Development, 68, 41-45. Previous research has documented that lesbians and gay men proceed through a series of stages in developing a positive lesbian and gay identity. The relationship between lesbian and gay identity and subsequent psychological adjustment has not been evaluated. These empirical studies found that positive lesbian and gay identity is related to psychological adjustment as measured by lower neurotic anxiety and greater ego strength in both an older and a younger sample of lesbians and gay men. Two coping strategies – self-labeling as a homosexual and self-disclosure of sexual orientation to others – were related to development of a positive lesbian or gay identity. These findings suggest that development of a positive lesbian or gay identity is an important task in promoting the psychological adjustment of lesbians and gay men.

Monteiro, K. P., & Fuqua, V. (1994). African-American gay youth: One form of manhood. High School Journal, 77 (1-2), 20-36. African-American gay men are treated as marginalized people within the margins of society. Acknowledging the virtual absence of empirical research on African-American male sexuality, this investigation focuses as much on redefining the theoretical questions which should shape new research as it will on reviewing the limited empirical research relevant to this topic. Data concerning African-American, male, same-sex desires is drawn broadly from empirical research, literary reference, documentary accounts, professional observations by the authors and one clinical consultant to this report, as well as two structured interviews of young, African-American gay men.

Morrow, D. F. (1993). Social Work with gay and lesbian adolescents. Social Work, 38 (6), 655-660. Gay and lesbian adolescents are a socially oppressed group discriminated against by a heterosexist and homophobic society. Because of the negative stigma society places on lesbian and gay adolescents, they face numerous difficulties that require social support and intervention. Issues pertinent to social work with lesbian and gay adolescents are examined in the context of three main social institutions: the family, the social culture, and the educational setting. Suggestions are made for improving intervention with this population, including increasing personal awareness of one’s own homophobia and heterosexist bias in working with client groups; educating oneself and client groups about homosexuality; establishing positive social support programs to serve lesbian and gay adolescents; advocating for sanctions to end gay and lesbian harassment in the educational system; supporting the hiring of openly gay and lesbian teachers to serve as positive role models; and advocating for the inclusion of sexual orientation information in school sex education curricula.

Muehrer, P. (1995). Suicide and sexual orientation: A critical summary of recent research and directions for future research. Suicide and Life Threatening Behavior, 25 (Suppl.), 72-81. Research on the hypothesized relationship between sexual orientation and suicide is limited both in quantity and quality. National or statewide data on the frequency and causes of completed suicide in gay and lesbian people in the general population, including youth, do not exist. Methodological limitations in the small research literature include a lack of consensus on definitions for key terms such as suicide attempt and sexual orientation, uncertain reliability and validity of measures for these terms, nonrepresentative samples, and a lack of appropriate nongay and/or nonclinical control groups for making accurate comparisons. These numerous methodological limitations prevent accurate conclusions about the role sexual orientation might play in suicidal behavior; the limitations also suggest opportunities for future research. Furthermore, recent evaluations of some school suicide-awareness programs suggest that these programs are ineffective and may actually have unintended negative effects. The premature dissemination of unproven programs is unwarranted.

Muller, L. E., & Hartman, J. (1998). Group counseling for sexual minority youth. Professional School Counseling, 1 (3), 38-41. School counselors who work with adolescent populations work with a silent minority of gay, lesbian, and bisexual youth. Because of this silence, counselors often assume that all students are heterosexual. This faulty belief sets up barriers to self-disclosure and support for sexual minority youth. Group counseling may be the best way to break through this barrier. This article reviews the issues facing sexual minority youth by presenting a model of a counseling group that was conducted in a public high school in Maryland.

Nardi, P. M. (1994). Gay and lesbian issues in the classroom. Yearbook (Claremont Reading Conference), 1994, 124-133. The author, a sociologist, addresses issues related to lesbian and gay youth by discussing how the major social institutions and related sociocultural factors continue to deny gays and lesbians equal treatment. So long as these institutions continue to practice institutionalized heterosexism, he contends, most of today’s young gays/lesbians will continue to experience a problematic and difficult search for personal identity.

Newman, B. S., & Muzzonigro, P. G. (1993). The effects of traditional family values on the coming out process of gay male adolescents. Adolescence, 28 (109), 213-226. A small sample of African-American, Hispanic/Latino, Asian/Eurasian, and Caucasian gay male adolescents participated in this survey study. Coming out was operationalized in three stages: sensitization; awareness with confusion, denial, guilt, and shame; and acceptance. The majority of respondents reported feeling different from other boys as children and confused during their first awareness that they were gay. Denial of identity was a coping strategy for about half the sample. Traditional family values played a greater role in predicting coming out experiences than did race. Families were categorized as having high or low traditional values based upon (1) the importance of religion, (2) emphasis on marriage, (3) emphasis on having children, and (4) whether a non-English language was spoken in the home. Families with a strong emphasis on traditional values were perceived as less accepting of homosexuality than were low traditional families.

Nichols, S. L. (1999). Gay, lesbian, and bisexual youth: Understanding diversity and promoting tolerance in schools. The Elementary School Journal, 99 (5), 505-519. Societal messages about normative culture permeate the lives of adolescents. Schools, as reflections of societal cultures, weave these messages throughout the informal curriculum by way of discipline, rules, and formal curricula. Many school climates foster norms, values, and belief systems that communicate rejection and intolerance to some students. In particular, gay, lesbian, and bisexual adolescents are a hidden minority in schools who are forced to negotiate homosexual identity development within typically homophobic climates. In this article, the author argues that schools are obligated to address the unique needs of homosexual youth because this population is at increased risk for committing suicide, physical and verbal abuse from peers, truancy, dropping out of school, and lowered self-esteem than their heterosexual counterparts. The author proposes that schools develop a diversity room and staff it with a specialist not only to meet the unique needs of homosexual adolescents, but also to encourage a sage, accepting climate for all students.

O'Conor, A. (1994). Who gets called queer in school? Lesbian, gay and bisexual teenagers, homophobia and high school. High School Journal, 77 (1-2), 7-12. Discussions of heterosexism, homophobia, and the lives of lesbian, gay, and bisexual youth have been noticeably absent in the educational literature. In 1992, the author spent several months observing and interviewing a group of gay, lesbian, and bisexual teenagers in a support group setting. In order to give voice to these teenagers, a composite narrative was constructed between two fictitiously named members, Christi, and Tommy. Their conversation reflects some of the most common and important experiences of these teenagers isolation, alienation, rejection by gay adults, hostility by parents, and problems with homophobia in and out of school.

Otis, M. D., & Skinner, W. F. (1996). The prevalence of victimization and its effect on mental well-being among lesbian and gay people. Journal of Homosexuality, 30 (3), 93-117. Research on victimization among oppressed groups such as lesbian and gay people has provided limited insight into its impact on the lives of those who are frequently targeted. This is due in part to small sample sizes and the absence of significant variables known to influence well-being. This analysis examines the prevalence and effects of victimization on a large sample (N=1067) of lesbians and gay men living in a southern state. Multiple regression is used to determine the psychosocial consequences of victimization as measured by depression. Additional factors thought to contribute, either positively or negatively, to the effect of victimization on mental well-being, i.e. social support, self-esteem, external stress, and internalized homophobia, are also included in the analysis. Results indicate that victimization has a significant positive effect on depression for both lesbians and gay men when controlling for other variables. Self-esteem was found to be the strongest predictor of depression for the entire sample. Social support was found to have a similar effect for lesbians and gay men with partner support and having no support being significant. Gender differences were found for measures of external stress, internalized homophobia, and age.

Omizo, M. M., Omizo, S. A., & Okamoto, C. M. (1998). Gay and lesbian adolescents: A phenomenological study. Professional School Counseling, 1 (3), 35-37. This research explored the personal feelings, perceptions, and thoughts of the participants using a semi-structured interview to gather information. Ten adolescents were used including eight boys and two girls ranging in age from 16 to 18 years. The answers to the questions were reduced to four categories including: (a) confusion and not being understood, (b) fear and negative reactions from others, (c) concern about the future, and (d) internalized hostility. The data also showed that the participants would like to live lives that are not filled with the fear of being found out or harassed. School counselors should be made aware that gay and lesbian youth need to talk about their concerns. Support groups could be founded and school personnel should be trained.

Owen, W. F., Jr. (1985). Medical problems of the homosexual adolescent. Journal of Adolescent Health Care, 6, 278-285. Physicians treating adolescents should take a complete sexual history, including sexual orientation and practices, to determine whether their patients are homosexually active. Lesbians are at very low risk for sexually transmitted diseases, but they do have other health concerns. Four general groups of conditions may be encountered in homosexually active men: classical sexually transmitted diseases (gonorrhea, infections with Chlamydia trachomatis, syphilis, herpes simplex infections, genital warts, pubic lice, scabies); enteric diseases (infections with Shigella species, Campylobactor jejuni, Entamoeba histolytica, Giardia lamblia, hepatitis A, hepatitis B, hepatitis non-A, non-B, and cytomegalovirus); trauma (fecal incontinence, hemorrhoids, anal fissures, foreign bodies, rectosigmoid tears, allergic proctitis, penile edema, chemical sinusitis, inhaled nitrite burns, and sexual assault of the male patient); and the acquired immunodeficiency syndrome (AIDS). Clinicians can assist homosexual teenagers by understanding their special health needs, by counseling them about safe sexual practices, and by accepting their relationships nonjudgmentally. [GMI]

Paroski, P. A. (1987). Health care delivery and the concerns of gay and lesbian adolescents. Journal of Adolescent Health Care, 8, (2), 188-192. One hundred twenty-one self-identified homosexual adolescents presenting to a New York City gay/lesbian community clinic were questioned over a period of 18 months concerning their perceived needs and health care requirements. These individuals reported using various traditional and nontraditional methods to learn about the homosexual lifestyle. Through this socialization many developed a stereotypic view of homosexuality and its associated lifestyle. Family discovery and other specific concerns of these patients are detailed. The implications of this psychosocial process are important to professionals who provide health care to adolescents.

Peters, A. J. (1997). Themes in group work with lesbian and gay adolescents. Social Work with Groups, 20 (2), 51-69. Lesbian and gay youth often face severe isolation, growing up in an environment that is frequently ignorant of their unique needs and hostile toward them. Youth groups can serve a vital role in overcoming this isolation in addition to providing a safe space for working out the various problems surrounding the stigma of growing up gay. This article presents several themes in group work with lesbian and gay adolescents based on the author’s experience as a group worker at a lesbian and gay youth project. Isolation, coming out, learning/re-learning, and initiation into a community are offered as four main themes which provide a foundation for understanding how to help lesbian and gay adolescents in groups.

Phillips, S., McMillen, C., Sparks, J., & Ueberle, M. (1997). Concrete strategies for sensitizing youth-serving agencies to the needs of gay, lesbian, and other sexual minority youths. Child Welfare, 76 (3), 393-409. In the past few years, several authors have detailed the needs of gay and lesbian youths and the obstacles youth-serving agencies face in addressing their needs. How administrators and practitioners can make changes in agencies that are not adequately serving sexual minority youths has been unclear. This article uses the experiences of two youth-serving agencies to offer recommendations on agency philosophies concerning the social realities of sexual minority youths and on several ways of creating a safe, welcoming, and productive environment.

Pilkington, N. W., & D’Augelli, A. R., (1995). Victimization of lesbian, gay, and bisexual youth in community settings. Journal of Community Psychology, 23, 34-56. One hundred ninety-four lesbian, gay, and bisexual youth between the ages of 15 and 21 were surveyed about victimization due to their sexual orientation. Three areas were assessed: (1) the prevalence of different kinds of victimization, ranging from verbal abuse to armed assault; (2) the specific social contexts in which anti-lesbian/gay victimization occurred, including family, school, work, and the broader community; and (3) correlates of anti-lesbian/gay victimization, including age-related sexual orientation milestones, concealability of sexual orientation, sex, race/ethnicity, and safety fears. Most respondents had experienced some form of victimization, with no social environment being free from risk of harm. Particularly vulnerable for abuse were youth who self-labeled or self-disclosed at an earlier age and those whose sexual orientation was less concealed or concealable.

Powell, R. E. (1987). Homosexual behavior and the school counselor. School Counselor, 34 (3), 202-208. The author’s purpose in this article is twofold: to examine some of the problems and issues that confront adolescent gay and lesbian students in the school environment, and to focus on an understanding of the sexual preference of these youths as a means of delineating roles for the school counselor. Some specific recommendations for the school counselor are also included.

Price, J. H. (1991). School counselors' perceptions of adolescent homosexuals. Journal of School Health, 61 (10), 433-438. Data from a national survey of secondary school counselors (N=289) were collected regarding their perceptions of adolescent homosexuality. Most counselors underestimated the prevalence of homosexual adolescents. Almost one in five counselors reported that counseling a homosexual student concerning gay issues would not be professionally gratifying, and 29% thought they were not very competent in counseling gay adolescents. One-fourth of the school counselors reported that teachers seem to exhibit significant prejudice toward homosexual students, and 41% believed schools are not doing enough to help gay students adjust to their school environment. Perceptions of adolescent homosexuality did not vary by gender, age, or education level of the counselors.

Proctor, C. D., & Groze, V. K. (1994). Risk factors for suicide among gay, lesbian, and bisexual youth. Social Work, 39 (5), 504-513. The study described in this article explores risk factors for suicide among gay, lesbian, and bisexual youths. A convenience sample of 221 self-identified gay, lesbian, and bisexual youths who attended youth groups across the United States and Canada were given the Adolescent Health Questionnaire, which assessed family issues, the social environment, and self-perceptions. The youths’ scores were significantly associated with suicidal ideation and attempts. Implications for social services are discussed.

Radkowsky, M., & Siegel, L. J. (1997). The gay adolescent: Stressors, adaptations, and psychosocial interventions. Clinical Psychology Review, 17 (2), 191-216. Social stigmatization hinders the ability of gay adolescents to achieve the tasks of adolescence. Because their sexual identity is denigrated by society, these youth have difficulty forming a positive identity and establishing healthy peer and intimate relationships. Family relations are often painful, and gay adolescents are susceptible to loneliness, isolation, depression, and suicide. Validation of these adolescents’ affectional and erotic feelings helps to normalize their adolescence, as does providing them with a peer group of other gay youth. [SOD]

Reese, S. (1997). The law and gay-bashing in schools. The Education Digest, 62, 46-49. The author discusses the need for schools to include sexual orientation in their anti-discrimination policies. Past litigation and recommendations for the future of education are reviewed.

Remafedi, G. (1993). The impact of training on school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality. Journal of School Health, 63 (3), 153-157. The impact of training on secondary school professional’s knowledge regarding HIV/AIDS and adolescent homosexuality was examined. Subjects (70 introductory and 50 advanced trainees) and 59 controls (no prior training) were systematically sampled from professionals in a statewide demonstration program to prevent HIV transmission among gay and bisexual youth. Subjects completed mailed, self-administered surveys based on the curriculum. The overall response rate was 79%. Trainees scored significantly higher than controls on knowledge pertaining to HIV and adolescent homosexuality. They also reported using greater numbers of strategies to teach students about homosexuality and to improve the milieu for homosexual students. Training at any level was independently associated with constructive behaviors, while controlling for demographic characteristics. Advanced learners were most knowledgeable and least reliant on informal sources of information. They were more likely than others to teach about homosexuality and to refer students to community services. Findings supported the hypothesized benefits of the intervention. Schools that mandate AIDS education should help staff confront the difficult issue of adolescent homosexuality.

Remafedi, G. J. (1987). Adolescent homosexuality: Psychosocial and medical implications. Pediatrics, 79(3), 331-337. Despite a widespread interest in the health of the gay community, the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment, education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases, running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out, and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed. [GMI]

Remafedi, G. J. (1985). Adolescent homosexuality: Issues for pediatricians. Clinical Pediatrics, 24 (9), 481-485. Homosexuality is among the most complex and controversial issues of adolescent health care. Although homosexual activity is common during adolescence, the prevalence and origins of homosexuality per se are poorly understood. Homosexual identity formation is a potentially tumultuous process that begins in childhood and extends through adulthood. The adolescent’s experiences my ultimately contribute to a variety of physical and mental health problems. The sociological, psychological, and medical issues are considered, and guidelines for the care of homosexual youths are proposed.

Remafedi, G., Farrown, J. A., & Deisher, R. W. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87 (6), 869-875. Studies of human sexuality have noted high rates of suicidality among homosexual youth, but the problem has not been systematically examined. This work was undertaken to identify risk factors for suicide attempts among bisexual and homosexual male youth. Subjects were 137 gay and bisexual males, 14 through 21 years of age, from the upper Midwest and Pacific Northwest. Forty-one subjects (41/137) reported a suicide attempt; and almost half of them described multiple attempts. Twenty-one percent of all attempts resulted in medical or psychiatric admissions. Compared with nonattempters, attempters had more feminine gender roles and adopted a bisexual or homosexual identity at younger ages. Attempters were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct. The findings parallel previous studies’ results and also introduce novel suicide risk factors related to gender nonconformity and sexual milestones.

Remafedi, G, French, S., Story, M, Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88 (1), 57-60. This study examined the relationship between sexual orientation and suicide risk in a population-based sample of adolescents. Participants were selected from a cross-sectional, statewide survey of junior and senior public high school students. All males (n=212) and females (n=182) who described themselves as bisexual/homosexual were compared with 336 gender-matched heterosexual respondents on three outcome measures: suicidal ideation, intent, and self-reported attempts. Logistic regression analyses were used to examine the association between sexual orientation and outcome measures with adjustment for demographic characteristics. Suicide attempts were reported by 28.1% of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but nor females, bisexual/homosexual orientation was associated with suicidal intent and attempts.

Remafedi, G., Resnick, M., & Blum, R. (1992). Demography of sexual orientation in adolescents. Pediatrics, 89, 714-721. This study was undertaken to explore patterns of sexual orientation in a representative sample of Minnesota junior and senior high school students. The sample included 34,706 students (grades 7 through 12) from diverse ethnic, geographic, and socioeconomic strata. Five items pertaining to sexual attraction, fantasy, behavior, and affiliation were embedded in a self-administered survey of adolescent health. Overall, 10.7% of students were “unsure” of their sexual orientation; 88.2% described themselves as predominately heterosexual; and 1.1% described themselves as bisexual or predominately homosexual. The reported prevalence of homosexual attractions (4.5%) exceeded homosexual fantasies (2.6%), sexual behavior (1%), or affiliation (0.4%). Gender differences were minor; but responses to individual sexual orientation items varied with age, religiosity, ethnicity, and socioeconomic status. Uncertainty about sexual orientation diminished in successively older age groups, with corresponding increases in heterosexual and homosexual affiliation. The findings suggest an unfolding of sexual identity during adolescence, influenced by sexual experience and demographic factors. [SOD]

Reynolds, A. L., & Koski, M. J. (1994). Lesbian, gay and bisexual teens and the school counselor: Building alliances. High School Journal, 77 (1-2), 88-94. The author recommends several strategies and competencies for the high school counselor dealing with lesbian, gay, and bisexual youth. These include: (1) providing support and affirmation, (2) knowledge and accurate information, (3) role modeling, and (4) the ability to be counselor/consultant/advisor.

Rhoads, R. A. (1995). Learning from the coming-out experiences of college males. Journal of College Student Development, 36 (1), 67-74. The findings of a 2-year ethnographic study of the coming-out experiences of gay and bisexual college men are presented. Four themes related to coming out are discussed: coming out as an ongoing process, personal changes related to coming out, negative experiences of coming out, and ongoing experiences of harassment and discrimination.

Ricketts, W. (1986). Homosexuality in adolescents: The reification of sexual personalities. Journal of Social Work and Human Sexuality, 5 (1), 35-49. The authors contend that a more useful model for understanding what we have come to consider sexual orientation is one not of singular personal identities, but one of relationships. Sections of this paper are devoted to an exploration of some of the assumptions underlying the literature on homosexuality and adolescence, and adumbrate the ways in which these biases have imposed their structure upon the professional interchange. [SOD]

Riddle, B. (1996). Breaking the silence. Independent School, 55, 38-40. Since each of our schools has a significant lesbian and gay population, since these students, teachers, and parents have needs and concerns that we have been ignoring for too long, and since everyone in our school community would benefit from increased awareness and education about homosexuality, what, then can we as independent schools do to break the silence and make our schools safer for and more nurturing of everyone? Plenty. In just about every area of school life, changes can (and eventually should ) occur - changes that for the most part require little effort, time, and money. This article attempts to show the reader how this could be done.

Rienzo, B. A., Button, J. W., & Wald, K. D. (1996). The politics of school-based programs which address sexual orientation. The Journal of School Health, 66, 33-40. This study examined both the context of school district programs related to sexual orientation, and the social and political determinants of these school programs. Data were collected from districts within all 126 U.S. communities with legal protection against discrimination on the basis of sexual orientation, and from a random sample of 129 U.S. jurisdictions without such legislation. Results showed that most school districts are not offering recommended program elements related to sexual orientation issues. Districts within localities with gay rights protection are doing more than those without. Although compositional factors account for some of the differences in educational efforts, a politically engaged constituency also made a major difference in school district efforts. To the extent that gays and lesbians served in public office and mobilized to influence school elections, they were able to affect school programs and politics.

Robinson, K. E. (1994). Addressing the needs of gay and lesbian students: The school counselor's roles. School Counselor, 41 (5), 326-332. Gay and lesbian youth are an isolated silent population that has generally been abandoned by society and overlooked by the counseling professions. In this article, the author explores the special needs of gay and lesbian youth and offers some suggestions for interventions from school counselors.

Rofes, E. E. (1994). Making our schools safe for sissies. High School Journal, 77 (1-2), 37-40. Despite twenty-five years of gay liberation work in the United States, there has been an overwhelming silence about gay men’s youthful experiences as sissies. The author discusses this topic; one he feels few of us want to touch.

Rofes, E. (1989). Opening up the classroom closet: Responding to the educational needs of gay and lesbian youth. Harvard Educational Review, 59 (4), 444-453. Eric Rofes, gay community activist and author, explores the issues surrounding the school’s failure to meet the educational needs of gay and lesbian youth. He argues that there has been an across-the-board denial of the existence of gay and lesbian youth, and that this has taken place because their voices have been silenced and adults have not effectively taken up their cause. Rofes goes on to present some promising initiatives that are designed to change the status quo: Project 10 in Los Angeles and the Harvey Milk School in New York City. He concludes by proposing needed changes in U.S. schools if they are to become truly accessible to gay and lesbian youth.

Rosario, M., Hunter, J., & Gwadz, M. (1997). Exploration of substance use among lesbian, gay, and bisexual youth: Prevalence and correlates. Journal of Adolescent Research, 12 (4), 454-476. The prevalence and correlates of substance use and abuse were explored among lesbian, gay male, and bisexual youth recruited from gay-focused organizations in New York City. Lifetime substance use was prevalent and frequent, as was quantity of use and substance abuse symptoms. Few significant gender or ethnic differences emerged, but the significant differences unexpectedly indicated that the female youth were at greater risk for substance abuse than the male youth. Number of substances ever used and substance abuse symptoms were associated with initiating alcohol and illicit drugs to cope with psychological issues. However, number of substances ever used and substance abuse symptoms were not explained by social learning theory, social control theory, or self-derogation theory when relations were explored. The findings are interpreted from the perspective of sexual identity, specifically that gay, lesbian, and bisexual youth may use substances to cope with the societal stigma of homosexuality.

Rosario, M., Rotheram-Borus, M, & Reid, H. (1996). Gay-related stress and its correlates among gay and bisexual male adolescents of predominantly Black and Hispanic background. Journal of Community Psychology, 24 (2), 136-159. The relationships among gay-related and non-gay-related stressful life events, self-esteem, emotional distress, and multiple problem behaviors (conduct problems, alcohol use, drug use, and sexual risk acts) were examined among 136 gay and bisexual male youths, predominantly Hispanic and Black, seeking social and recreational services at a gay-identified community-based agency in New York City. Increasing levels of gay-related stressful life events were associated moderately with emotional distress and multiple problem behaviors. In addition, high self-esteem was related to low levels of emotional distress. However, self-esteem did not buffer the relationships between gay-related stressful life events and emotional distress or multiple problem behaviors. Future research should examine the chronic impact of gay-related stressful life events on gay and bisexual youths and identify the resources that allow the youths to cope with this stress.

Ross, M. W. (1990). The relationship between life events and mental health in homosexual men. Journal of Clinical Psychology, 46 (4), 402-411. In a study to determine the extent to which stigmatization influences mental health in homosexual men, 80 homosexual men were administered the General Health Questionnaire and the Gay Affect and Life Events Scale. Data indicate that there were significant associations between life events and mental health; events related to AIDS had the highest correlations. However, general life event scales that included Finances and Work also were associated significantly with mental health, as previously reported in the general population. These data suggest that the impact of life events may be amplified by stigmatization and that the degree of life changes is associated closely with psychological dysfunction. It is concluded that life events that are related to both stigmatization and life change and related emotional distress are significant predictors of psychological dysfunction. [SOD]

Rotheram-Borus, M. J., & Fernandez, M. I. (1995). Sexual orientation and developmental challenges experienced by gay and lesbian youths. Suicide and Life-Threatening Behavior, 25 (Suppl.), 26-34. Youths with a homosexual orientation face different developmental challenges during adolescence than those faced by heterosexual youths or individuals who recognize their homosexual orientation later in life. We discuss the impact of “coming out,” or defining a homosexual orientation, on the development and identity formation of youths who come out during adolescence. The process of coming out is presented as entailing four broad dimensions: recognizing oneself as lesbian or gay; exploring one’s sexual orientation through the gay and lesbian community; disclosing one’s sexual orientation to others; and becoming more comfortable with one’s sexual orientation. Some of the major challenges faced by these youth are described, and future directions for research efforts are discussed. [SOD]

Rotheram-Borus, M. J., Meyer-Bahlburg, H. F. L., Rosario, M., Koopman, C., Haignere, C. S., Exner, T. M., Matthieu, M., Henderson, R., & Gruen, R. S. (1992). Lifetime sexual behaviors among predominately minority male runaways and gay/bisexual adolescents in New York City. AIDS Education and Prevention, Fall, (Suppl.), 34-42. Lifetime sexual behaviors were examined among two samples of predominately minority, male adolescents in New York City aged 12 to 18 (M=16.3), believed to be at high risk for HIV infection: 59 runaway males in two residential shelters and 60 males attending a community agency (HMI) for gay and bisexual youths. Interviews regarding psychosocial milestones indicated that 93% of these youths had engaged in oral, anal, or vaginal intercourse and/or anilingus, with a median of 7.0 male partners among HMI males. Both groups initiated sexual activity at a relatively early mean age of 12.6 years. Each group reported a unique developmental sequence of psychosexual milestones. Consistent condom use was reported by 13% of the youths. One quarter of the youths reported involvement in prostitution. These findings detail the need for AIDS prevention programs for these youths.

Rotheram-Borus, M. J., Hunter, J., & Rosario, M. (1994). Suicidal behavior and gay-related stress among gay and bisexual male adolescents. Journal of Adolescent Research, 9 (4), 498-508. Adolescents are increasingly at risk for attempting suicide, particularly among those subgroups experiencing high stress. Typically, adolescent females are at far greater risk (10.3% attempt suicide) as compared to males (6.2% attempt suicide). In contrast to rates among adolescents in community-based studies, attempted suicide was reported by 39% of a consecutive series of 138 self-identified gay and bisexual males, ages 14 through 19 years, presenting at a social service agency for lesbian and gay adolescents in New York City. More than one-half of attempters had tried to kill themselves more than once, and suicide attempters were more likely to have dropped out of school, to be ejected from their homes, and to have friends or relatives who attempted suicide. Gay-related stressors were significantly more common among suicide attempters as compared to nonattempters, but general life stress was not higher. These finding imply that gay youths are at increased risk for attempting suicide. Clinicians and staff in community-based agencies need to enhance their awareness of suicide attempts among gay and bisexual male youths, increasing screening for risk and actively seeking to reduce gay-related stress.

Rotheram-Borus, M., & Koopman, C. (1991). Sexual risk behavior, AIDS knowledge, and beliefs about AIDS among predominately minority gay and bisexual male adolescents. AIDS Education and Prevention, 3, (4), 305-312. Current sexual risk behavior, AIDS knowledge, and beliefs about AIDS prevention were examined among 59 black and Hispanic male adolescents attending a community center for gay and lesbian youth. Most (73%) were sexually active in the last 3 months, with a median of 2.0 partners and with only 21% reporting consistent condom use. These youths demonstrated moderately high AIDS knowledge (82%) and positive beliefs endorsing AIDS prevention (71%). When risk pattern was defined on the basis of partners, risk acts, and condom use, positive AIDS prevention beliefs were significantly and inversely associated with the high-risk pattern, but not with abstinence. These results suggest that youths who frequently engage in high-risk acts need intervention targeting changes in beliefs and behavior, as well as knowledge.

Rotheram-Borus, M., Rosario, M., Meyer-Bahlburg, H. F. L., Koopman, C., Dopkins, S. C., & Davies, M. (1994). Sexual and substance use acts of gay and bisexual male adolescents in New York City. Journal of Sex Research, 31 (1), 47-57. Lifetime and current sexual and substance use behaviors were examined among 131 predominantly Hispanic and Black gay and bisexual adolescent males in New York City. Many youths engaged in anal sex with males (80%), and bartered sex for money or drugs (22%). Condom use with male partners typically was initiated one year after a youth became sexually active, was more common with male than female partners, and was more common with anal than with oral sex. Condoms with male partners were never or inconsistently used by 52% of youths. Youths reported high rates of lifetime alcohol (76%), marijuana (42%) and cocaine/crack (25%) use; none reported intravenous drug use. Current alcohol and drug use was significantly related to sexual risk acts. These findings indicate that HIV-prevention programs for homosexual and bisexual male youths are critical and must address sex with females, inconsistent condom use, and sexual practices while under the influence of drugs and alcohol.

Rotheram-Borus, M., Rosario, M., Van Rossem, R., Reid, H., & Gillis, R. (1995). Prevalence, course, and predictors of multiple problem behaviors among gay and bisexual male adolescents. Developmental Psychology, 31 (1), 75-85. Multiple problem behaviors, stress, and personal resources were assessed over 2 years among 136 mainly Black and Hispanic gay and bisexual male adolescents age 14-19 years. Whereas sexual risk acts, substance abuse, conduct problems, and emotional distress were common, the risk acts did not form a multiple problem behavior cluster, compared with previous findings with heterosexual youths. Problem behaviors were stable over time: Only 20% to 30% of the youths changed their pattern of problem behaviors over 2 years. For each individual, the pattern of change in one behavior problem was not related to patterns of change in other problem behaviors over 2 years. At baseline, personal resources were associated with less alcohol use and emotional distress, and stress was associated with delinquent behaviors. The pattern of results was similar whether youths labeled themselves as gay or bisexual, suggesting that problem behaviors among mainly Black and Hispanic gay and bisexual youths may follow different developmental pathways than among heterosexual youths.

Ryan, C. C., Bradford, J. B., & Honnold, J. A. (1999). Social workers’ and counselors’ understanding of lesbian needs. Journal of Gay & Lesbian Social Services, 9, (4), 1-25. An exploratory survey was conducted in 1994 to assess mental health providers’ experience with lesbian clients and understanding of lesbians. Probability samples of 250 licensed clinical social workers and 250 licensed professional counselors were randomly generated from Virginia licensure lists. A total of 183 out of 224 respondents were active practitioners and were included in the analysis. Ninety-seven percent of active practitioners reported their sexual orientation; of these, 7% identified as lesbian, gay, or bisexual. Twenty-two percent of respondents had received training or education in lesbian mental health issues (19% of heterosexuals and 58% of lesbians, gays, and bisexuals) and most viewed coming out as more positive than negative. Most heterosexual providers defined lesbianism in terms of sexual attraction only, while lesbian, gay, and bisexual providers defined lesbianism in both behavioral (sexual) and affectional terms. Providers who thought certain mental health symptoms varied on the basis of sexual orientation generally thought lesbians experienced these more frequently. Lesbian, gay, and bisexual providers reported a larger number of lesbian clients, defined lesbianism more appropriately, and understood lesbian mental health issues more clearly. Based on study results, lesbians who seek mental health care in Virginia can expect to receive more informed mental health services from lesbian, gay, and bisexual providers.

Saltzburg, S. (1996). Family therapy and the disclosure of adolescent homosexuality. Journal of Family Psychotherapy, 7, (4), 1-18. Family support is a crucial predictor of adolescent health and adjustment. When the parents of gay/lesbian adolescents first learn of their child’s homosexual identity, support and nurturing are frequently withdrawn. Because the primary task of parenting lies in the ability to nurture and protect one’s child, the parent-child relationship is the most natural place to begin helping parents adjust to the child’s disclosure. It is essential to the adolescent’s well-being that they believe that the attachment figures understand their situation and are responsive to their emotional needs. The focus of this article is to examine the parent-adolescent relationship in the face of the disclosure of the child’s homosexuality, and to look to family therapy as the intervention of choice for preserving the parent’s capacity for nurturing the child.

Saunders, J. M., & Valente, S. M. (1987). Suicide risk among gay men and lesbians: A review. Death Studies, 11, 1-23. Without adequate death statistics from completed suicide data, the suicide risk for gay men and lesbians must be determined from empirical studies and from a theoretical understanding of suicide risk. Three large, well designed studies found that gay men and lesbians attempt suicide two to seven times more often than heterosexual comparison groups. Gay men and lesbians have significantly high rates of risk factors that increase suicide risk such as suicide attempts, alcohol abuse, drug abuse and interrupted social ties. Durkheim suggests that groups with low social status and integration who are denied society’s usual privilege and rights are at risk for alienation and anomic suicide unless protected by internal cohesion, religion, or antisuicide norms. Durkheim’s theory applied to gay amen and lesbians illustrates how the extensive and diverse alienation reported may lead to suicide. Diverse groups of gay people have not yet successfully decreased alienation or suicide. Empirical evidence, risk factors and Durkheim’s theory of anomic suicide thus supports the proposition that gay men and lesbians are at high risk for suicide. The need for sensitive research methodology, decreased heterosexual bias, creative network sampling strategies, and confidentiality are discussed. Future research should clarify the completed suicide rates among diverse groups of homosexuals of different ages, sex, race, and demographic variables.

Savin-Williams, R. C. (1998). The disclosure to families of same-sex attractions by lesbian, gay, and bisexual youths. Journal of Research on Adolescence, 8 (1), 49-68. Developmental psychologists generally have ignored the processes by which sexual-minority adolescents come to recognize themselves as gay, lesbian, or bisexual and to disclose that information to others. One of the most critical events for sexual-minority adolescents is disclosing their sexual identity to family members. In this article, empirical research is addressed that documents the percentage of youths who disclose to their families, the time during the coming-out process that youths disclose to family members, and the manner in which disclosure occurs. Mother-father differences are explored, and, when applicable, data on disclosure to siblings and extended family members are reviewed. The implications of these findings for youths, parents, and the family system are summarized and future research needs are suggested.

Savin-Williams, R. C. (1995). An exploratory study of pubertal maturation timing and self-esteem among gay and bisexual male youths. Developmental Psychology, 31 (1), 56-64. Eighty-three gay and bisexual male youths (17-23 years old) completed questionnaires and a structured interview. Pubertal maturation was associated with self-reported age of first orgasm and homosexual activity and frequency of orgasms during junior high school. Unrelated were age of first same-sex attractions, sexual orientation, age of first heterosexual activity, frequency of orgasms during high school, number of lifetime male and female sex partners, reactions to puberty, and self-esteem. Early and on-time maturers rarely varied from each other on the assessed domains. Youths did not differ in self-esteem level from heterosexual male youths. Gay and bisexual male youths share with heterosexual male youths a similar developmental trajectory in regard to pubertal maturation and self-esteem. [SOD]

Savin-Williams, R. C. (1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Psychology, 62 (2), 261-269. A common theme identified in empirical studies and clinical reports of lesbian, gay male, and bisexual youths is the chronic stress created by the verbal and physical abuse they receive from peers and adults. This article reviews the verbal and physical abuse that threatens the well-being and physical survival of lesbian, gay male, and bisexual youths. This response by significant others in their environment is often associated with several problematic outcomes, including school-related problems, running away from home, conflict with the law, substance abuse, prostitution, and suicide. Although the causal link between these stressors and outcomes has not been scientifically established, there is suggestive evidence that these outcomes are consequences of verbal and physical harassment.

Savin-Williams, R. C. (1989). Parental influences on the self-esteem of gay and lesbian youths: A reflected appraisals model. Journal of Homosexuality, 17 (1-2), 93-109. Based on a population of 317 gay and lesbian youths, the current investigation explores the appropriateness of a reflected appraisals perspective in predicting the degree to which parental attitudes, as perceived by youth, affects their self-esteem and comfortableness being gay. A lesbian was most comfortable with her sexual orientation if she also reported that her parents accepted her homosexuality; these variables did not, however, predict her level of self-esteem. Among the gay males, parental acceptance predicted comfortableness being gay if the parents were also perceived as important components of a youth’s self-worth; a male most comfortable with his sexual orientation had the highest level of self-esteem. Results are discussed in terms of : (a) sex of parent, (b) sex-role development, (c) comparisons of gays and lesbians, and (d) research of gay and lesbian youth.

Savin-Williams, R. C. (1989). Coming out to parents and self-esteem among gay and lesbian youths. Journal of Homosexuality, 18 (1-2), 1-35. The significance of the parents for the coming out process and for the self-evaluation of 317 gay and lesbian youths between the ages of 14 and 23 years was assessed in the current study. Responses from a 10-page questionnaire are analyzed, and these finding are discussed in the context of sex differences for both adolescents and parents, the importance of the parents for the self-esteem of gay and lesbian youth, and limitations of the current investigation.

Savin-Williams, R. C. (1989). Gay and lesbian adolescents. Marriage and Family Review, 14 (3-4), 197-216. Distinguishing among sexual orientation, behavior, and identity is a primary goal of this paper. Another is to reduce the invisibility of lesbian and gay adolescents to social scientists, health care providers, the lesbian and gay communities, gay/lesbian youths and their parents. Finally, a third goal is to alert parents and health care providers to some of the issues, such as irrational fears, peer ridicule, lack of support, and misunderstandings, that are directly responsible for the poor physical and psychological health of some lesbian and gay youth.

Savin-Williams, R. C. (1988). Theoretical perspectives accounting for adolescent homosexuality. Journal of Adolescent Health, 9 (2), 95-104. Few topics in sexology elicit such a diversity of opinions and emotions as the question of etiology of homosexuality. Views frequently carry with them implicit or explicit messages concerning the psychologic health of this sexual orientation. Theories of sexual development usually portray adolescence as a critical time in the life course because of changes in : 1) anatomy and physiology; 2) psychologic functioning; the reawakening, renewal, and reliving of previously established sexual relations and drives; and/or 3) social conditions: an increased exposure and adherence to societal messages concerning appropriate and inappropriate social and sexual behaviors and relationships. This paper provides a brief overview of several major theories – evolutionary biology, psychoanalysis, and social processes – as they relate to the development of sexual orientation. In addition, an ethologic perspective that synthesizes various etiologic theories, as they relate to homosexuality during adolescence, is briefly reviewed. In these discussions, the issue of whether homosexuality is a normal or abnormal developmental state during adolescence is also addressed. [SOD]

Savin-Williams, R. C. (1987). An ethological perspective on homosexuality during adolescence. Journal of Adolescent Research, 2 (3), 283-302. An ethological perspective is presented as an alternative to traditional developmental approaches to adolescence. From an evolutionary point of view, the onset of reproductive capability during adolescence marks the significance of this time during the life course. Thus, the apparent anomaly of male and female youth preferring not to engage in heterosexual activities that have the potential to maximize genetic fitness but to participate in homosexual activities that do not have the same adaptive repercussion poses a challenge for an ethological perspective to interpret. To better understand an ethological perspective, basic ethological principles are applied to the emergence and expression of homosexuality during adolescence. First, evidence bearing on the genetic etiological underpinnings of homosexuality within humans is reviewed through an examination of (a) behavioral genetic studies and (b) hormonal research. Next, adaptive considerations are presented, in particular the prevalence of homosexual behavior among various animal species and human societies, as well as evolutionary pressures that maintain a stable level of homosexuality in the human population. Balanced polymorphism and kin selection are reviewed as answers to the ultimate or functional question. Finally, the naturalness of adolescent homosexuality as an outcome of an ethological perspective is proposed. Homosexuality is thus presented as a sexual orientation that is not so much a matter of choice but of biological necessity. [SOD]

Schmitt, J. P., & Kurdek, L. A. (1987). Personality correlates of positive identity and relationship involvement in gay men. Journal of Homosexuality, 13 (4), 101-109. Six personality variables (social anxiety, trait anxiety, locus of control, sensitization, depression, and self concept) were correlated with variables relevant to a positive gay identity (degree of communication about sexual preference and degree of comfort being gay) and to relationship involvement (being in a gay relationship, number of months in a gay relationship, and living with a partner) in a volunteer, nonclincal sample of 51 gay males. Men who informed others of their sexual preference were low on trait anxiety, sensitization, and depression and high on self concept. Men comfortable with their gay identity were low on social anxiety, sensitization, and depression and high on self concept. Men involved in long-term relationships were low in trait anxiety, had an internal locus of control, and were low on depression. Men living with a partner had a higher self concept then men not living with a partner. Results are discussed in terms of previous studies of gay male relationships.

Schneider, M. (1993). Educating the public about homosexuality. Annals of Sex Research, 6, 57-66. Factors which result in the erroneous link between homosexuality and pedophilia are discussed. The author proposes that homosexuality is stigmatized because it is perceived to be a threat to prescribed gender roles. The accusation of pedophilia is one of the most effective aspects of homophobia and heterosexism which serves to stigmatize gays and lesbians. Educational strategies are proposed which will help correct misconceptions about homosexuality.

Schneider, M. (1991). Developing services for lesbian and gay adolescents. Canadian Journal of Community Mental Health, 10 (1), 133-151. The needs of lesbians and gay adolescents for service provision are discussed in this paper. These needs are identified through research investigating milestones in the coming-out process. In addition, the way in which the research results influenced community development initiatives is discussed. The social context in which the research was conducted is also described.

Schneider, M. (1989). Sappho was a right-on adolescent: Growing up lesbian. Journal of Homosexuality, 17 (1-2), 111-130. Beginning with the interaction between the coming-out process and adolescent development, this paper explores the young lesbian experience. The words and perceptions of over 20 young lesbians are used to depict the experiences from their own points of view. The data reported were gathered over a period of two years, beginning in the summer of 1984. A relatively unstructured interview was used, lasting from 1 to 3 hours. Participants were asked to describe (a) how they realized they were lesbian, (b) what they did about it, and (c) how they felt about it at different points in the process. Themes that became conspicuous include (a) identity, (b) self-esteem, and (c) socialization: friendship, intimacy, and community. Quotations are used which, in the opinion of the author, illustrate the scenes poignantly. [SOD]

Scheinder, M. S., & Tremble, B. (1986). Gay or straight? Working with the confused adolescent. Journal of Social Work and Human Sexuality, 4 (1-2), 71-82. This article examines the issues around working with adolescents who are confused regarding their sexual orientation. The areas of discussion include: (a) the role of confusion in adolescent development and in the coming out process; (b) the sources of confusion regarding sexual orientation for both the ultimately gay and ultimately straight youth; (c) working with the confused adolescent; and (d) areas of confusion for the social worker.

Schneider, S. G., Farberow, N. L., & Kruks, G. N. (1989). Suicidal behavior in adolescent and young adult gay men. Suicide and Life-Threatening Behavior, 19 (4), 381-394. The relationship of homosexuality to suicidal behavior was explored by questionnaire responses from 52 men in gay-and-lesbian college organizations and 56 men in gay rap groups. A family background of alcoholism and physical abuse, social supports perceived as rejecting of homosexuality, and no religious affiliation were associated with a history of suicidal ideation, reported by 55% of the participants. Racial/ethnic minorities tended to be overrepresented among suicidal as compared to nonsuicidal gay men. Suicide attempts, reported by 20% of the sample, were most often associated with intrapersonal distress, and occurred most often while individuals were “closeted” and/or in the context of recent rejection for being homosexual. Nearly all attempters were aware of their homosexual feelings, but had not yet established a “positive gay identity” at the time of their first suicide attempt. Suicidal behavior in gay youths may be the product both of familial factors that predispose youths to suicidal behavior, and of social and intrapersonal stressors involved in coming to terms with an emerging homosexual identity.

Sears, J. T. (1994). Challenges for educators: Lesbian, gay, and bisexual families. High School Journal, 77 (1-2), 138-156. If we are to truly serve all of our students, then educators must become more aware of the challenges facing lesbian, gay, and bisexual parents. This article addresses these challenges, as well as the challenges faced by children with lesbian, gay, or bisexual parents. A discussion about homosexuality is provided, as well as a summary of the research in the area of lesbian, gay, and bisexual families.

Sears, J. T. (1991). Educators, homosexuality, and homosexual students: Are personal feeling related to professional beliefs? Journal of Homosexuality, 22 (3-4), 29-79. This study is based upon interviews with Southern lesbian and gay young adults and survey data from school counselors and prospective teachers living in the South. The essay explores adolescent’s perceptions of the beliefs and abilities of school counselors and teachers with regard to issues of homosexuality and the treatment of gay and lesbian students. As a complement and a contrast, it also presents educators personal beliefs about homosexuality, and how these attitudes are actualized in the schools. One major conclusion is that while school counselors, and, to a lesser extent, classroom teachers often expressed the feeling that they should be more proactive and supportive as professionals committed to the welfare of all students, due to countervailing expressions of high levels of personal prejudice, ignorance, and fear, the realities of their professional intervention and support were negligible.

Shaffer, D., Fisher, P., Hicks, M. P., Gould, M. (1995). Sexual orientation in adolescents who commit suicide. Suicide and Life-Threatening Behaviors, 25 (Suppl.), 64-71. It has been suggested that there is a strong relationship between suicidal behavior and homosexuality in adolescence. It has been further suggested that it is due to the stigmatization and feelings of isolation that are experienced by many gay adolescents. Much of the literature that has given support to these hypotheses has been conducted on uncontrolled nonrepresentative samples and its generalizability is open to question. An opportunity to examine the relationship in an unselected sample arose in a case control, psychological autopsy study of 120 of 170 consecutive suicides under age 20 and 147 community age, sex, and ethnic matched controls living in the Greater New York City area. Homosexuality was defined as having had homosexual experiences or having declared a homosexual orientation. Three teenagers and no controls met these criteria. The difference was not significant. The circumstances of death were examined and are described. In no instance did suicide directly follow an episode of stigmatization. All three suicides had evidence of significant psychiatric disorder before death. In spite of opportunities for biased reporting, it is concluded that this study finds no evidence that suicide is a common characteristic of gay youth, or that when suicide does occur among gay teenagers, that it is a direct consequence of stigmatization or lack of support.

Silvestre, A. J., Kingsley, L. A., Weham, P., Dappen, R., Ho, M., Rinaldo, C. R. (1993). Changes in HIV rates and sexual behavior among homosexual men, 1984 to 1988/92. American Journal of Public Health, 83, 578-580. Data were collected from 1614 homosexual and bisexual men in 1984 through 1985 and from 1988 to 1992 in Pittsburgh. Of the men entering the study since 1988, 16% reported engaging in unprotected anal receptive intercourse with more than one partner during the 6 months before their visit. Approximately 7% of the younger men and 18% of the men over 22 years of age in the recent cohort were already infected with the human immunodeficiency virus, the same rated as those described 8 years ago. Aggressive risk-reduction programs are needed in high schools and existing networks in the gay community.

Singerline, H. (1994). OutRight: Reflections on an out-of-school gay youth group. High School Journal, 77 (1-2), 133-137. Outright! is the name of an out-of-school gay youth group located in Durham, North Carolina. This article describes Outright! whose members believe no young person should be subjected to ending the mutilation of a child's spirit based upon her or his sexual orientation.

Smith, G., Kippax, S., Chapple, M. (1998). Secrecy, disclosure, and closet dynamics. Journal of Homosexuality, 35 (1), 53-73. This paper examines the assumption that male homosexuality has a natural affinity with femininity and that male heterosexuality has a natural affinity with masculinity. An analysis of the relationship between people’s disclosure or concealment of their homosexual practice or identity, particularly as it relates to notions of hegemonic masculinity and femininity provides the focus of this paper. It is argued that everyday understandings of homosexuality tend to be resolved in such a way as to press homosexuality into the service of privileging a male, masculine, and heterosexual subjectivity. The privileging is achieved, in part, as a result of the everyday social practices of homosexually active men’s witting and unwitting deference to the hegemonic presumption that masculine men are naturally heterosexual, and its inverse, that feminine men are homosexual and are a perturbation of the natural order. We argue that this correlation is manufactured in everyday life in the world of appearances, but that the appearance of things is not reflected at a level of practice, which is to say, male homosexual practice is not necessarily feminine, just as male heterosexual practice is not necessarily masculine. Realities that conflict with hegemonic realities are masked in the public world, for a variety of reasons. What we have called closet dynamics are the various discourses through which homosexuality is concealed and disclosed, and the various subject positions people take up in relation to those discourses.

Snider, K. (1996). Race and sexual orientation: The impossibility of these intersections in educational policy (critique of the Toronto Board of Education's Triangle Program). Harvard Educational Review, 66, 294-302. In this article, Kathryn Snider critiques the Toronto School Board of Education’s Triangle Program, a program designed for lesbian and gay youth who are at risk of dropping out of high school. She questions whether this program, which provides support for students coping with issues of sexual identity, can really work for lesbian and gay youth of color unless it also includes strategies that acknowledge how issues of sexual orientation interact with issues of racial identity. She locates this critique within the larger context of the Board’s approach to multiculturalism and diversity in the schools. Rather than implementing a program that further marginalizes and isolates lesbian and gay students by removing them from mainstream education, Snider suggests that schools must make fundamental changes that work to eliminate racism and homophobia within the dominant educational structure.

Sobocinski, M. R. (1990). Ethical principals in the counseling of gay and lesbian adolescents: Issues of autonomy, competence, and confidentiality. Professional Psychology, 21, (4), 240-247. Ethical dilemmas in counseling gay and lesbian adolescents are analyzed according to underlying ethical principals. Developmental issues and their relevance to therapy are emphasized. Conflicts among client autonomy, claims of paternalism, and limits of confidentiality are examined. Competence to enter therapy for issues of sexual identity is assessed. The author concludes that adolescents are generally competent to explore issues of sexual identity.

Straight, A. M. (1995). The Massachusetts Safe School Program: A stepping stone for gay and lesbian high school students. Educational Record, 76, 70-71. This article describes both the Safe School Program adopted by the Massachusetts State Board of Education, and the implementation of one of the nation's first college-level programs to take a proactive approach to the issues surrounding gay and lesbian students at Northeastern University.

Strathdee, S. A., Hogg, R. S., Martindale, S. L., Cornelisse, P. G. A., Craib, K. J. P., Montaner, J. S. G., O’Shaughnessy, M. V., & Schecter, M. T. (1998). Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 19, 61-66. Data from a cohort of young HIV-negative gay and bisexual men were analyzed to identify determinants of sexual risk-taking at baseline. Gay/bisexual men aged between 18 and 30 completed a self-administered questionnaire including demographics, depression, social support, substance use, and consensual versus nonconsensual sex. Risk-takers were defined as those who had unprotected anal sex with casual male sex partners in the previous year; non-risk-takers were defined as those who reported consistent condom use during anal sex with all male partners in the previous year. Logistic regression was used to identify independent predictors of sexual risk taking. Of 439 men studied, risk-takers had less education, a higher depression score, less social support, and were more likely to report nonconsensual sex and recreational drug use relative to non-risk-takers. Independent predictors of sexual risk-taking were low education, nitrite use, low social support (adjusted odds ratio [AOR] = 1.65; 95% CI, 1.04-2.59), and nonconsensual sex experienced as a youth or adult (AOR = 1.85; 95% CI, 1.15-2.96). Young gay/bisexual men reporting nonconsensual sex, low social support, or nitrite use were significantly more likely to have recently had unprotected anal sex with casual partners. HIV prevention programs aimed at young gay/bisexual men should include sexual abuse counseling and foster community norms supporting safer sex practices.

Stratton, S. D., & Backes, J. S. (1997). Sexual harassment in North Dakota schools: A study of eight high schools. High School Journal, 80 (3), 163-172. Sexual harassment is any unwanted or unwelcome sexual behavior that interferes with a persons life. Sexual harassment in schools can occur between a faculty member and a faculty member, a faculty member and a student, or a student and a student. The researchers identified North Dakota public high schools of various sizes to use for this study. High school senior participants (n=178) completed a survey that was a modified version of The American Association of University Women (AAUW) and Louis Harris and Associates nationwide study of sexual harassment of students. Looking at the results, 82.8% of the male participants and 93.3% of the female participants indicated that they had experienced sexual harassment in school. The sexual harassment behavior that was significantly different between males and females was being called gay or lesbian. Less than 10% of the females reported having ever been called gay or lesbian, compared to 37.5% of the males. Both male and female students identified the opposite sex more frequently as their harassers, but males identified other males more frequently than females identified other females. Both males and females identified the following as the most frequent type of sexual harassment experienced: made sexual comments, jokes, gestures, or looks.

Street, S. (1994). Adolescent male sexuality issues. School Counselor, 41 (5), 319-325. The American School Counselor Association (ASCA) identifies three major counselor responsibilities in comprehensive developmental guidance programs: (a) counseling, (b) consultation, and (c) coordination (defined as the process of managing various indirect services that benefit students, such as acting as a liaison between the community and the school). School counselors can provide numerous supportive services to address male sexuality issues. The purpose of this article is to examine two adolescent male sexuality issues/sexual abuse and homosexuality-within the ASCA’s designated tripartite school counselor role. [SOD]

Sturdevant, M. S., Remafedi, G. (1992). Special health needs of homosexual youth. Adolescent Medicine, 3, (2), 359-371. According to best estimates, at least 1 out of 10 teenagers is struggling with issues concerning sexual orientation. These teens face multiple threats to healthy psychosocial developmental and emotional well-being. Homosexual youngsters generally are “invisible” within health care settings and, consequently, underserved. This paper provides a developmental framework for understanding the psychosocial and medical problems that threaten the health of this group of adolescents. Its goals are to describe the special health needs of homosexual youth and to outline the role of the health professional in reaching and caring for them. [GMI]

Sullivan, T. (1994). Obstacles to effective child welfare service with gay and lesbian youths. Child Welfare, LXXIII,(4), 291-304. Agencies attempting to develop effective child welfare services for gay and lesbians youths must strive for effectiveness within a policy context that is politically polarized and generates more obstacles than directions. This article argues for a reconceptualization of service delivery that begins with a recognition of the unique developmental challenges facing sexual minority youths and proceeds to an examination of the systemic obstacles to providing competent services in their behalf. An ecological perspective informs the connections between developmental considerations, service issues, and human rights questions.
Sullivan, T., & Schneider, M. (1987). Development and identity issues in adolescent homosexuality. Child and Adolescent Social Work Journal, 4 (1), 13-24. This paper argues that homosexual emergence in adolescence must be viewed from a developmentally non-pejorative perspective. In attempting to respond to the special stresses in adolescents who are developing gay or lesbian identities, helping professionals need to develop a familiarity with the unique developmental tasks of gay and lesbian youth, as well as the sexual identity formation literature generally. A review of developmental issues for gay and lesbian youth leads to some thoughts regarding the development of services. [SOD]

Sullivan, T. R. (1996). The challenge of HIV prevention among high-risk adolescents. Health & Social Work, 21, 58-65. This article reports findings from an exploratory study of HIV knowledge and risk behaviors among 60 teenagers and young men engaged in the street life of Hollywood, California. The sample was composed largely of youths of homosexual or bisexual orientation who were substance abusers, prostitutes, or both. The data suggest that although community-based education efforts may be associated with lower-risk behavior among this population, the overall risk profiles of these socially marginalized youths remained high. Inferences are drawn about the cofactors of risk that must be addressed and the education needed to enhance the health prospects of these youths.

Teague, J. B. (1992). Issues relating to the treatment of adolescent lesbians and homosexuals. Journal of Mental Health Counseling, 14, (4), 422-439. Homosexuality as a life-style can be many things to many people. For the gay or lesbian adolescent, it can lead to confusion, isolation, or a number or other serious problems such as attempted suicide. As a means of finding support and accurate information, these teens may seek out a mental health professional. This article reviews the current theoretical literature with respect to a number of key issues that can help mental health counselors be more aware and more effective in their delivery of services to this population. Etiological, developmental, treatment, and resource issues are highlighted and suggestions for future research are provided.

Tellez, C., Ramos, M., Umland, B., Palley, T., & Skipper, B. (1999). Attitudes of physicians in New Mexico toward gay men and lesbians. Journal of the Gay and Lesbian Medical Association, 3 (3), 83-88. Previous studies suggest that negative attitudes held by many physicians toward gay men and lesbians may adversely affect this population’s health care. This study examined the attitudes of physicians toward homosexuality through a questionnaire mailed to 1949 physicians in New Mexico. The questionnaire included a validated attitudinal scale. Each respondent was categorized as homophilic, neutral, or homophobic based on their responses. We had a 53.6% response rate. Over 8% of male respondents had homophobic scores versus 1.6% of female respondents. Of those practicing in cities with populations between 25,000 and 50,000, 20.6% had homophobic scores versus 4.5% of those practicing in larger cities and 6.4% of those in more rural areas. Multivariate analysis showed that gender, specialty, community size, and personal experiences help determine whether a physician is likely to hold negative attitudes toward gay men and lesbians. Our study found less homophobia among physicians than reported previously; however, we found that negative attitudes toward homosexuality persist in medicine. This study is the first to measure homophobia among physicians working in smaller cities; this may affect the quality of care available to lesbians and gay men who reside in these areas.

Telljohann, S. K., & Price, J. H. (1993). A qualitative examination of adolescent homosexuals' life experiences: Ramifications for secondary school personnel. Journal of Homosexuality, 26 (1), 41-46. The purpose of this qualitative study was to examine life experiences of homosexual youths in regard to selected topics of relevance to high school personnel. An open-ended questionnaire was given to 120 homosexual youths (14 to 21 years of age), 89 males and 31 females. Approximately one third of the students claimed they knew they were homosexual between the ages of four and ten, with equal numbers aware of their sexual orientation 11-13 years of age and 14-17 years of age. Forty-two percent of the females and 30% of the males indicated that their families responded in a negative manner toward them because of their sexual orientation. Only about one fourth of the students claimed they were able to talk with school counselors about the issue. Half of the students claimed that homosexuality had been discussed in their classes and 50% of the females and 37% of the males claimed it was handled negatively. Less than one in five students could identify someone who had been supportive of them. Further information is reported regarding the challenges schools will need to address to play a role in reducing the stresses faced by a significant minority of the population.

Telljohann, S. K., Price, J.H., & Poureslami, M. (1995). Teaching about sexual orientation by secondary health teachers. The Journal of School Health, 65, 18-22. Less than half of a random sample (N=211) of high school health teachers formally teach about homosexuality. When taught, it most commonly is taught for less than one class period. Only one-in-four teachers perceived themselves as very competent in teaching about homosexuality. This is not surprising given the fact that teachers were most likely to identify the mass media as the most commonly used source of information regarding homosexuality. One-in-five teachers claimed students in their classes often used abusive language when describing homosexuals. One-third of health teachers indicated gay and lesbian rights are a threat to the American family and its values. However, one-third of the health teachers perceived the schools were not doing enough to help homosexual adolescents. Finally, more than half the health teachers indicated gay/lesbian support groups would not be supported by their school administrator. Perceptions and behaviors regarding adolescent homosexuality varied by the teachers gender, age, educational level, and teaching status regarding homosexuality.

Travers, R., & Schneider, M. (1996). Barriers to accessibility for lesbian and gay youth needing addictions services. Youth and Society, 27, (3), 356-378. Using a qualitative research method, this study investigates the ways in which homophobia and heterosexism constitute barriers to treatment for lesbian and gay youth in need of addictions services. Seventeen lesbian and gay youth were interviewed regarding their experiences in addictions services. The major barriers that they report include marginalization, avoidance of gay and lesbian issues, ignoring sexual orientation as an issue, deflection and contradiction, outing, harassment, early discharge, and misinformed staff. Recommendations are made for making addictions services more appropriate and accessible for lesbian and gay youth.

Treadway, L, et al. (1992). Creating a safer school environment for lesbian and gay students. Journal of School Health, 62 (7), 352-357. Information obtained from clinical experiences of the University of Minnesota Youth and AIDS Project (YAP), a primary AIDS prevention program for gay and bisexual males age 14-21, is described. More than 300 YAP clients have been interviewed regarding sexual behavior, suicide attempts, drug use, and experiences in disclosing their homosexuality to peers and parents during their high school years. The authors also have drawn from their experiences as support group leaders for gay, lesbian, and bisexual youth in high school community settings. Constructive and destructive coping strategies employed by gay, lesbian, and bisexual students are described. Roles and responsibilities of school professionals to create a safer school environment also are presented. Key issues include how school professionals support or deny the existence of homosexuality in young people; how adult’s biases against homosexuality, as well as institutionalized heterosexism, prevent lesbian and gay students from succeeding in school; how language, behaviors, and environmental cues contribute to school professional’s approachability; how children of lesbian and gay parents suffer when negative attitudes toward homosexuality are not challenged; and what resources and referrals can help lesbian and gay young people.

Tremble, B., Schneider, M., & Appathurai, C. (1989). Growing up gay in a multicultural context. Journal of Homosexuality, 17 (3-4), 253-267. This study is an investigation of the influence of ethnicity on the relationships of gay and lesbian young people and their families. A framework for conceptualizing the influence of culture is presented. Modes of family responses are described and the conflicts involved in maintaining an ethnic identity, and a gay or lesbian identity, are discussed. Implications for researchers and practitioners are identified.

Troiden, R. R. (1988). Homosexual identity development. Journal of Adolescent Health Care, 9 (2), 105-113. This paper presents an ideal-typical model of homosexual identity development that describes how committed homosexuals (i.e., women and men who see themselves as homosexual and adopt corresponding lifestyles) recall having developed perceptions of themselves as homosexual. The model consists of four stages: sensitization, identity confusion, identity assumption, and commitment. Often-repeated themes in the life histories of lesbians and gay males, clustered according to life stages, provide the content and characteristics of each stage. [SOD]

Turock, B. J. (1996). Locked out (attempts to remove books and other materials from school media centers). The American School Board Journal, 183, 31-33. The freedom to think and read what we choose without censorship or limitation is one of this nation's most precious freedoms. But in local school districts these days, it is a freedom that seems increasingly fragile. Included in this attack are materials addressing gay and lesbian issues.

Uribe, V. (1994). Project 10: A school-based outreach to gay and lesbian youth. High School Journal, 77 (1-2), 108-112. Negative biases regarding gays and lesbians have often been espoused by critical persons within the homosexual child's educational milieu. This article addresses these issues by describing the Project 10 model school program in Los Angeles, talking about parental relationships with gay and lesbian youth, gay and lesbian teens of color, and tips for school administrators who face gay- and lesbian-related situations.

Uribe, V., & Harbeck, K. M. (1991). Addressing the needs of lesbian, gay, and bisexual youth: The origins of PROJECT 10 and school-based intervention. Journal of Homosexuality, 22 (3-4), 9-28. This research chronicles the formation and expansion of a counseling and educational program for gay, lesbian, and bisexual youth called PROJECT 10 at Fairfax High School. A model program was tested during the academic year 1985-1986, and is now being implemented throughout the Los Angeles Unified School District and in other schools across the nation. Fifty self-identified homosexual students were interviewed in order to clarify the needs of lesbian, gay, and bisexual teenagers in relation to their school experiences. Additionally, a questionnaire study of 342 respondents from the general student population was undertaken in order to chart the beliefs and attitudinal changes of those teenagers who experienced school-based educational programs that portrayed homosexuality and bisexuality as variations on a continuum of human sexual expression and emotional attachment. Suggestions for further research are discussed.

Van de Ven (1995). Talking with juvenile offenders about gay males and lesbians: Implications for combating homophobia. Adolescence, 30,(117), 19-42. Violence against gay males and lesbians, much of it perpetrated by young people, has emerged as a significant social problem. Thirty-one juvenile offenders were asked a series of structured questions in order to elucidate the functions their attitudes toward homosexuals serve. In addition, responses were examined for evidence of social-structural and cognitive variables which mediate offending behaviors. Juvenile offenders were found to hold attitudes toward homosexuals characterized by negativity, ambivalence, and defensiveness. These attitudes were maintained by particular myths and stereotypes about gay and lesbian culture, and were related to Opportunism, Impulsivity, Role-Taking Inability, and Disabilities in Social Problem Solving. Specific recommendations for combating homophobic attitudes and behaviors in juvenile offender populations are discussed.

Van de Ven, P. (1994). Comparisons among homophobic reactions of undergraduates, high school students, and young offenders. The Journal of Sex Research, 31, (2), 117-124. To re-examine the relationships among gender, age, education, and anti-homosexual prejudice, homophobic reactions of undergraduate (n=97), high school students, and young offenders (n=37) were compared on five variables: cognition, homophobic anger, and delight; and behavioral intentions. Multivariate analyses with post hoc Tukey-HSD multiple comparisons revealed, contrary to previous reports and expectations, that the relationships among gender, age, education, and homophobia were complex. Females were less hostile toward homosexuals on all variables except delight, on which there were no gender differences. On cognition and homophobic guilt, undergraduates were less homophobic than high school students, who in turn were less homophobic than young offenders. On homophobic anger and behavior, high school students and young offenders responded similarly, but both groups expressed more homophobia on these two variables than did undergraduates. No between-group differences were found on the delight variable. Results indicated strong resistance to homosexuals, particularly in the high school and young offenders cohorts, reinforcing the need to promote tolerance toward homosexuality. The discussion underscores the importance of including samples from a wide range of social environments, not just colleges and universities, and using multiple dependent measures of homophobic reaction.

Vare, J. W., & Norton, T. L. (1998). Understanding gay and lesbian youth: Sticks, stones, and silence. The Clearing House, 71 (6), 327-331. Gay and lesbian adolescents confront many of the same biological, cognitive, and social developmental changes as their heterosexual counterparts. Difficulties in social, emotional, and physical well-being can arise for gay and lesbian youth, however, from both overt and covert homophobia, which devalue sexual identity orientations that are not what the majority perceives as normal. By learning about the concerns of gay and lesbian youth, middle and high school educators can break the barrier of silence that contributes to the difficulties of these teens. This article is meant to give educators a more adequate knowledge of the developmental difficulties that gay and lesbian teens encounter and behaviors that place them at risk. [SOD]

Vermund, S. H., Hein, K., Gayle, H. D., Cary, J. M., Thomas, P. A., & Drucker, E. (1989). Acquired immunodeficiency syndrome among adolescents: Case surveillance profiles in New York City and the rest of the United States. American Journal of Diseases of Children, 143, 1220-1225. Adolescents engaging in certain sexual or drug-related behavior are at risk of contracting the human immunodeficiency virus infection in endemic locales. Local and national surveillance data were analyzed to determine the characteristics of the acquired immunodeficiency syndrome (AIDS) epidemic in adolescents. Of the 605 cases of AIDS in people aged 13 to 21 years reported through 1987, 518 were males (83 from New York City [NYC], NY), and 87 were females (28 from NYC). Over half of all adolescent males with AIDS reported homosexual contact. Transfusion/blood product-related human immunodeficiency virus acquisitions (especially in males with hemophilia) represented 11% of adolescent cases from NYC (1% of NYC adults) and 22% of adolescent cases in the United States (US) outside of NYC (4% of adults in the US). Intravenous drug use was more frequently reported among adolescents with AIDS from NYC (23%) than among adolescents outside NYC (14%). In females, heterosexual transmission accounts for about half of all adolescent AIDS cases and 29% of all adult cases. Age-appropriate services and behavioral interventions are urgently needed for high-risk adolescents.

Vinkes, J, & Bolton, R. (1994). Social support, depression, and self-acceptance among gay men. Human Relations, 47 (9), 1049-1062. This study analyzes how low social support of gay men when coming out affects the reported level s of depression and self-acceptance in a non-clinical sample of Flemish (Belgium) gay men. The model used is nonrecursive. It incorporates the mutual causation between depression and self-acceptance. The manipulation of social support is considered as part of the general process of social control. After delineating the methodological problems associated with studying the relationship between the perception of support and depression, it is shown that low social support because one is gay leads first to depression and then to low levels of gay self-acceptance. Findings are discussed within the framework of social stress research and the characteristics of the social context of the setting where the data was collected.

Waldner, L. K. & Magruder, B. (1999). Coming out to parents: Perceptions of family relations, perceived resources, and identity expression as predictors of identity disclosure for gay and lesbian adolescents. Journal of Homosexuality, 37 (2), 83-100. This paper examines perceptions of family relations, identity expression, and pro-lesbian/gay resources as factors influencing coming out to parents. One hundred seventy-two adolescents responded to a survey originating from a clinical support group for lesbian and gay youth. Findings indicate that weak family relations significantly detract from coming out to parents indirectly through identity expression and perceived resources. Excluding the effects of family relations, adolescents perceiving supportive resources and expressing their lesbian/gay identity were more likely to come out to parents.

Waldner-Haugrud, L. K., & Magruder, B. (1996). Homosexual identity expression among lesbian and gay adolescents: An analysis of perceived structural associations. Youth and Society, 27 (3), 313-333. Theoretical and empirical analysis of homosexual identity neglects the influence of structural factors on identity expression. The Negotiated Identity Model proposes that perceptions of external forces influence adolescents through supportive resources and obstacles that may inhibit identity expression. Snowball sampling provided 172 self-identified homosexual adolescents, including 85 lesbians and 87 gay males. Perceptions of structural associations tested included religiosity, importance of school, political ideology of parents, socioeconomic status (SES) of parents, importance of heterosexual friends, frequency of heterosexual sexual encounters, importance of heterosexual sexual encounters, and gender nonconformity. Multiple regression analysis explained more of the variance for gay men than for lesbians. Variables important for gay males included political ideology, SES, heterosexual friends, and gender nonconformity. Significant variables for lesbians included religion and importance of school. Gender differences are discussed as well as implications for adolescents. [SOD]

Walters, A. S. (1999). HIV prevention in street youth. Journal of Adolescent Health, 25, 187-198. Homeless adolescents have remained an underserved population throughout the human immunodeficiency/acquired immune deficiency syndrome epidemic. This article reviews the recent literature investigating human immunodeficiency virus (HIV) risk behavior among street youth. Prevalence rates of both adolescent homelessness and HIV seropositivity are unknown. However, data from a number of samples document a high prevalence of HIV risk behavior, sexually transmitted diseases, and alcohol/drug use among homeless adolescents. A number of individual and social factors, often associated with street survival, propel adolescents toward high-risk behavior. For some adolescents, testing HIV positive is perceived as advantageous in the procurement of basic needs such as food and shelter. HIV risk-reduction interventions must take into consideration the cause of homelessness, access to and participation in shelter services, and individual factors (such as the effects of sexual orientation and ethnicity) that frequently have not been systematically included in previous research. HIV risk for many homeless adolescents stems directly from their state of homelessness. National policies and funding are needed to address the health needs of these youth.

Walters, A. S., & Hayes, D. M. (1998). Homophobia within schools: Challenging the culturally sanctioned dismissal of gay students and colleagues. Journal of Homosexuality, 35 (2), 1-23. In this paper, the authors chronicle the prevalence of and cultural prescription for homophobia in the United States. The endemic nature of homophobia as it has been studied by behavioral scientists is reviewed. The authors then suggest that as social institutions reflecting cultural values, schools, colleges, and universities sanction an environment that neglects the values of gay students, staff, and faculty. Institutional homophobia dismisses the legitimacy of these individuals, thereby minimizing their contributions to learning. Addressed specifically are suggestions for training individuals who work with students to recognize, address, and challenge homophobia. The authors conclude that while the weight of American culture sanctions homophobia, training educators and personnel about the nuances of institutional homophobia may provide a fairer environment for gay students and colleagues. An appendix of resources describing effective programs for educational and training use is provided.

Watter, D. N. (1987). Teaching about homosexuality: A review of the literature. Journal of Sex Education and Therapy, 13 (2), 63-66. This paper assesses the current status of the literature available about homosexuality. Attention is given to specific teaching strategies as well as the studies indicating the efficacy of these strategies for the classroom. It is concluded that most reports in the literature are largely anecdotal and more specific investigation is needed.

Well, J. W., & Kline, W. B. (1987). Self-disclosure of homosexual orientation. Journal of Social Psychology, 127 (2), 191-197. An open-ended questionnaire, assessing how, when where, why and to whom 23 gay men and 17 lesbians in the United States disclose their sexual orientation revealed a high degree of selectivity and fear of rejections, as well as checking out the reviewer’s views about homosexuality before disclosing what is considered as intimate data. Respondents cited honesty, developing meaningful relationships, education of non-gays, and maintaining a positive self-image as major considerations in self-disclosing their sexual orientation. Gender differences were found between women and men supporting traditional sex-role socialization.

Whatley, M. H. (1992). Images of gays and lesbians in sexuality and health textbooks. Journal of Homosexuality, 22 (3-4), 197-211. Photographs have become a major form of illustration in college level health and sexuality textbooks and may be more memorable than the text itself. Unlike other forms of illustration, photographs are often viewed as objective and unable to lie. Photographs of individuals from nondominant groups, in addition to being seen as objective representations of reality, are often seen as representing the group to which they belong. To study the representation of nondominant groups in textbooks, it is, therefore, as important to analyze the photographs as it is the text itself. This paper examines photographs of gay men and lesbians in 14 health and 16 human sexuality college level textbooks. The photographs of individuals present an inaccurate portrait of lesbians and gay men as white, young, and physically-abled. Individual and large group photographs of activism (31% of the photographs of gay men and lesbians) were positive images that emphasized issues of civil rights. The paper discusses various interpretations of the photographs of gay men and lesbians, subtle homophobia or heterosexism in the texts, and progress that has been made.

Williams, P. (1989). Teaching about homosexuality. Independent School, 48, 17-18. The study of homosexuality enables all of us to reconsider what it means to be human. The author discusses his experiences having guests lecturers discuss homosexuality in his classrooms, including parents' reactions to having the topic raised in their child's classroom.
Working Groups, Workshop on Suicide and Sexual Orientation. (1995). Recommendations for a Research Agenda in Suicide and Sexual Orientation. Suicide and Life-Threatening Behavior, 25 (Suppl.), 82-88. Workshop participants were divided into four concurrent working groups to develop recommendations for future research in suicide and sexual orientation. The working groups were organized around four broad themes: (1) conceptual foundations for studies of suicide and sexual orientation, (2) research design for the study of suicide and sexual orientation, (3) measurement and sampling issues, and (4) research ethics. This summary is intended to integrate the principal recommendations for research in suicide and sexual orientation offered by the working groups, and, at the same time, reflect the rich diversity of perspectives represented by the workshop participants.

Zera, D. (1992). Coming of age in a heterosexist world: The development of gay and lesbian adolescents. Adolescence, 27 (108), 849-854. The general developmental struggles of gay and lesbian adolescents are described as delineated in recent research. Three developmental areas were selected as a focus: the consolidation of sexual identity and the effects of both parental and peer relationships on gay adolescent’s development. Weaknesses are noted in current research and theory, and suggestions are offered which could facilitate the development of both homosexual and heterosexual youth. [SOD]